Organization
FLORIDA OTOLARYNGOLOGY GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE STEPHANIE MAKUTA (OFFICE MANAGER)
(407) 351-0675
Entity
Organization
Contact information
Practice address
7251 UNIVERSITY BLVD, SUITE 300, WINTER PARK, FL 32792-8659
(407) 677-0099
Mailing address
7251 UNIVERSITY BLVD, SUITE 300, WINTER PARK, FL 32792-8659
(407) 677-0099
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060823800
—
FL
Enumeration date
11/02/2006
Last updated
12/08/2009
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