Provider Demographics
NPI:1689763815
Name:ORLANDO ALTAMONTE OB GYN ASSOC PA
Entity Type:Organization
Organization Name:ORLANDO ALTAMONTE OB GYN ASSOC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:POSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-862-8643
Mailing Address - Street 1:693 DOULGAS AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714
Mailing Address - Country:US
Mailing Address - Phone:407-862-8643
Mailing Address - Fax:407-862-4042
Practice Address - Street 1:693 DOULGAS AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714
Practice Address - Country:US
Practice Address - Phone:407-862-8643
Practice Address - Fax:407-862-4042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36556207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D57056Medicare UPIN
FL59282Medicare ID - Type Unspecified