Individual
DR. AKALUCK THATAYATIKOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2501 N ORANGE AVE STE 586, ORLANDO, FL 32804-4603
(407) 821-3545
(407) 821-3546
Mailing address
2501 N ORANGE AVE STE 586, ORLANDO, FL 32804-4603
(407) 821-3545
(407) 821-3546
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
2006035310
MO
2080P0216X
Pediatric Rheumatology Physician
Primary
ME114452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007298300
—
FL
Enumeration date
05/21/2007
Last updated
12/13/2021
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