Provider Demographics
NPI:1376509521
Name:MILLA-ORELLANA, PAULINO (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULINO
Middle Name:
Last Name:MILLA-ORELLANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 E ALTAMONTE DRIVE STE 217
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701
Mailing Address - Country:US
Mailing Address - Phone:407-339-3030
Mailing Address - Fax:407-339-3003
Practice Address - Street 1:661 E ALTAMONTE DRIVE STE 217
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-339-3030
Practice Address - Fax:407-339-3003
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058262208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064188000Medicaid
GA11432OtherBCBS
539537428OtherPEDICARE
539537428OtherPCN
593537428OtherCHAMPUS/TRICARE
FL064188000Medicaid
FL065786OtherVISTA HEATHPLAN
593537428OtherUNITED AMERICAN INS
593537428OtherHMAA
213436OtherAVMED
3515974007OtherCIGNA
4203919OtherAETNA
593537428OtherFIRST HEALTH NETWORK
593537428OtherHEALTH AND WELFARE
593537428OtherHEALTH AND WELFARE
FL064188000Medicaid