Provider Demographics
NPI:1558774224
Name:UF CANCER CENTER AT ORLANDO HEALTH
Entity Type:Organization
Organization Name:UF CANCER CENTER AT ORLANDO HEALTH
Other - Org Name:ORLANDO HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOJTECZKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-841-1869
Mailing Address - Street 1:1400 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2134
Mailing Address - Country:US
Mailing Address - Phone:321-841-1869
Mailing Address - Fax:
Practice Address - Street 1:1414 KUHL AVE
Practice Address - Street 2:MP 710
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2008
Practice Address - Country:US
Practice Address - Phone:321-841-6947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPAT9107947363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty