Provider Demographics
NPI:1417669011
Name:FAMILY MEDICINE OF ORLANDO PLLC
Entity Type:Organization
Organization Name:FAMILY MEDICINE OF ORLANDO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-802-3233
Mailing Address - Street 1:2295 S HIAWASSEE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-8748
Mailing Address - Country:US
Mailing Address - Phone:407-802-3233
Mailing Address - Fax:
Practice Address - Street 1:801 N ORANGE AVE STE 710
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-5202
Practice Address - Country:US
Practice Address - Phone:407-343-7242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY MEDICINE OF ORLANDO PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty