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Organization

CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY A PROFESSIONAL ASSOCIATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAMELA L HENRY (OFFICE MANAGER)
(407) 898-1436
Entity
Organization

Contact information

Practice address
801 N ORANGE AVE STE 815, ORLANDO, FL 32801-5203
(407) 898-1436
(407) 898-6330
Mailing address
2501 N ORANGE AVENUE, SUITE 442, ORLANDO, FL 32804
(407) 898-1436
(407) 898-6330

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0110014
AETNA
01
168900414910
HUMANA
01
51884
FL HOSP HEALTHCARE SYSTEM
FL
01
97149
BCBS OF FL
FL
Enumeration date
06/02/2006
Last updated
12/04/2019
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