ORLANDO SPORTS MEDICINE GROUP INC NPI 1023129178

NPI Information

NPI: 1023129178
Provider Name: ORLANDO SPORTS MEDICINE GROUP INC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
12780 WATERFORD LAKES PKWY
SUITE 115
ORLANDO, FL
ZIP 32828
Phone: (407) 207-7188
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ORLANDO SPORTS MEDICINE GROUP INC is a multi-specialty clinic center in Orlando, FL. ORLANDO SPORTS MEDICINE GROUP INC NPI is 1023129178. The provider is registered as an organization entity type.

The provider's business location address is:

12780 WATERFORD LAKES PKWY
SUITE 115
ORLANDO, FL
ZIP 32828-500
Phone: (407) 207-7188
Fax: (407) 207-7103

The provider's authorized official is Eric Greeno .
The authorized official title is President and has the following contact phone number (407) 207-7188.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/19/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Y902T	OTHER	FLORIDA	BLUE CROSS BLUE SHIELD
2	K8482	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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