Provider Demographics
NPI:1609575786
Name:THE UNIVERSITY OF CENTRAL FLORIDA BOARD OF TRUSTEES
Entity Type:Organization
Organization Name:THE UNIVERSITY OF CENTRAL FLORIDA BOARD OF TRUSTEES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FOR HEALTH AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:GERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-266-1000
Mailing Address - Street 1:6850 LAKE NONA BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7408
Mailing Address - Country:US
Mailing Address - Phone:407-266-1309
Mailing Address - Fax:
Practice Address - Street 1:3280 PROGRESS DR STE 500
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-2903
Practice Address - Country:US
Practice Address - Phone:407-266-2343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE UNIVERSITY OF CENTRAL FLORIDA BOARD OF TRUSTEES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular MedicineGroup - Multi-Specialty