Provider Demographics
NPI:1215190962
Name:OVIEDO FAMILY HEALTH CENTER PA
Entity Type:Organization
Organization Name:OVIEDO FAMILY HEALTH CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PINKAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-366-7455
Mailing Address - Street 1:6012 ALOMA WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9786
Mailing Address - Country:US
Mailing Address - Phone:407-366-7455
Mailing Address - Fax:407-359-8410
Practice Address - Street 1:6012 ALOMA WOODS BLVD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9786
Practice Address - Country:US
Practice Address - Phone:407-366-7455
Practice Address - Fax:407-359-8410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty