Provider Demographics
NPI:1174560858
Name:ORLANDO HEALTH INC
Entity type:Organization
Organization Name:ORLANDO HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP REVENUE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:EGGERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-237-6393
Mailing Address - Street 1:89 W COPELAND DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2028
Mailing Address - Country:US
Mailing Address - Phone:407-237-6319
Mailing Address - Fax:407-843-8505
Practice Address - Street 1:89 W COPELAND DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2028
Practice Address - Country:US
Practice Address - Phone:407-237-6319
Practice Address - Fax:407-843-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72628OtherBCBS OF FLORIDA
FL036396100Medicaid
FL036396100Medicaid