Provider Demographics
NPI:1487663779
Name:ORLANDO PSYCH GROUP, P.A.
Entity Type:Organization
Organization Name:ORLANDO PSYCH GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAVEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-849-0227
Mailing Address - Street 1:7300 SANDLAKE COMMONS BLVD 315
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819
Mailing Address - Country:US
Mailing Address - Phone:407-849-0227
Mailing Address - Fax:407-423-5484
Practice Address - Street 1:7300 SANDLAKE COMMONS BLVD 315
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-849-0227
Practice Address - Fax:407-423-5484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00459632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043151600Medicaid
FL043151600Medicaid
FLD55151Medicare UPIN