Provider Demographics
NPI:1073088977
Name:HAYE, OMAR
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:HAYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 HIGHLAND VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5331
Mailing Address - Country:US
Mailing Address - Phone:301-633-0101
Mailing Address - Fax:
Practice Address - Street 1:114 W UNDERWOOD ST STE A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1138
Practice Address - Country:US
Practice Address - Phone:407-885-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3994171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist