Provider Demographics
NPI:1619286267
Name:ORBITAL AND OCULO FACIAL CONSULTANTS, P.A.
Entity Type:Organization
Organization Name:ORBITAL AND OCULO FACIAL CONSULTANTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-870-2057
Mailing Address - Street 1:2088 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2307
Mailing Address - Country:US
Mailing Address - Phone:941-870-2057
Mailing Address - Fax:941-870-3608
Practice Address - Street 1:2068 HAWTHORNE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2307
Practice Address - Country:US
Practice Address - Phone:941-870-2057
Practice Address - Fax:941-870-3608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty