Individual
MARY BRIDGET HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 S ORANGE AVE, ORLANDO, FL 32806-2134
(407) 648-3800
(407) 425-5203
Mailing address
1400 S ORANGE AVE, ORLANDO, FL 32806-2134
(407) 648-3800
(407) 425-5203
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
ME0064493
FL
2085N0904X
Nuclear Radiology Physician
ME0064493
FL
2085R0202X
Diagnostic Radiology Physician
ME0064493
FL
2085R0203X
Therapeutic Radiology Physician
ME0064493
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23058
BCBS
FL
01
—
360003245
MEDICARE RR
—
05
—
373223100
—
FL
01
—
3805400
UNITED HEALTH CARE
—
Enumeration date
07/29/2006
Last updated
06/21/2010
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