Provider Demographics
NPI:1598087231
Name:WOMEN'S HEALTHCARE OF ORLANDO, PA
Entity Type:Organization
Organization Name:WOMEN'S HEALTHCARE OF ORLANDO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLO PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-453-2072
Mailing Address - Street 1:PO BOX 781444
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32878-1444
Mailing Address - Country:US
Mailing Address - Phone:407-453-2072
Mailing Address - Fax:
Practice Address - Street 1:3701 AVALON PARK WEST BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7303
Practice Address - Country:US
Practice Address - Phone:407-453-2072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 104799261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCX948ZOtherASSOCIATED INDIVIDUAL MEDICARE NUMBER
FL002284400OtherINDIVIDUAL MEDICAID NUMBER
FLGROUP CX949AOtherGROUP MEDICARE NUMBER
FL1073735270OtherINDIVIDUAL PROVIDER NPI
FL001933000OtherGROUP MEDICAID NUMBER