Organization
ORLANDO HEALTH INC
Active
Other names
OH General Pediatrics & Adolescent Med.
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH EGGERT (VP REVENUE MANAGEMENT)
(407) 237-6393
Entity
Organization
Contact information
Practice address
89 W COPELAND DR, 2ND FLOOR, ORLANDO, FL 32806-2028
(407) 237-6319
(407) 843-8505
Mailing address
89 W COPELAND DR, 2ND FLOOR, ORLANDO, FL 32806-2028
(407) 237-6319
(407) 843-8505
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036396100
—
FL
01
—
72628
BCBS OF FLORIDA
FL
Enumeration date
06/01/2006
Last updated
09/30/2008
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