Individual
ANTHONY E DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
670 N ORLANDO AVE, SUITE 204, MAITLAND, FL 32751-4481
(407) 644-7551
(407) 644-7121
Mailing address
670 N ORLANDO AVE, SUITE 204, MAITLAND, FL 32751-4481
(407) 644-7551
(407) 644-7121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME84368
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13399
BCBS
FL
01
—
P00044141
RAILROAD MEDICARE
—
Enumeration date
05/18/2006
Last updated
08/17/2007
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