Organization
TREVISANI ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY EAGLE (ADMINISTRATOR)
(407) 886-2050
Entity
Organization
Contact information
Practice address
4151 HUNTERS PARK LN, SUITE 140, ORLANDO, FL 32837-3617
(407) 764-9500
(407) 764-9502
Mailing address
4151 HUNTERS PARK LN, SUITE 140, ORLANDO, FL 32837-3617
(407) 764-9500
(407) 764-9502
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DN13576
FL
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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