Provider Demographics
NPI:1457489767
Name:ORLANDO HEALTH INC
Entity Type:Organization
Organization Name:ORLANDO HEALTH INC
Other - Org Name:ORLANDO REGIONAL PEDIATRIC ANESTHESIA CONSULTANTS
Other - Org Type:Doing Business As
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:321-843-6805
Mailing Address - Street 1:102 W. PINELOCH AVE.
Mailing Address - Street 2:SUITE 23
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806
Mailing Address - Country:US
Mailing Address - Phone:407-481-7174
Mailing Address - Fax:407-481-7190
Practice Address - Street 1:1414 KUHL AVE.
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:407-481-7174
Practice Address - Fax:407-481-7190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5000-0576991207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric AnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL036396102Medicaid
FL036396102Medicaid