Organization
FLORIDA HOSPITAL MEDICAL GROUP INC
Active
Other names
Orlando Neurosurgery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN STILTZ (PRESIDENT)
(407) 200-2733
Entity
Organization
Contact information
Practice address
1605 W FAIRBANKS AVE, WINTER PARK, FL 32789-4603
(407) 975-0200
(470) 975-0209
Mailing address
1605 W FAIRBANKS AVE, WINTER PARK, FL 32789-4603
(407) 975-0200
(470) 975-0209
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268791700
—
FL
01
—
34958
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
08/22/2005
Last updated
10/18/2012
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