Provider Demographics
NPI:1376534701
Name:ORLANDO, MICHAEL RICHARD (CRNA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RICHARD
Last Name:ORLANDO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 CREEKSIDE BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108
Mailing Address - Country:US
Mailing Address - Phone:239-261-1158
Mailing Address - Fax:239-261-4232
Practice Address - Street 1:311 9TH STREET NORTH
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102
Practice Address - Country:US
Practice Address - Phone:239-261-1158
Practice Address - Fax:239-261-4232
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1937912367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
G3430OtherBC/BS
FL306109400Medicaid
FL306109400Medicaid