Individual
MR. ANTHONY PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 650-1300
(407) 650-1307
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 650-1300
(407) 650-1307
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9103334
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003881800
—
FL
01
—
201095753
TAX ID
FL
01
—
PA9103334
MEDICAL LICENSE
FL
Enumeration date
09/23/2005
Last updated
11/14/2016
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