Organization
SURGICAL GROUP OF WINTER PARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH ROBINSON BENNETT D.O (PRESIDENT)
(407) 673-9992
Entity
Organization
Contact information
Practice address
2828 CASA ALOMA WAY, SUITE 100, WINTER PARK, FL 32792-2223
(407) 673-9992
(407) 673-9902
Mailing address
232 OSCEOLA CT, WINTER PARK, FL 32789-4431
(407) 673-9992
(407) 673-9902
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS0003899
FL
2086S0129X
Vascular Surgery Physician
OS0003899
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
OS0003899
FL
Other
Enumeration date
05/25/2010
Last updated
08/22/2013
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