Provider Demographics
NPI:1689877748
Name:UNIVERSITY OF CENTRAL FLORIDA
Entity Type:Organization
Organization Name:UNIVERSITY OF CENTRAL FLORIDA
Other - Org Name:UCF STUDENT HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:DEICHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-823-6000
Mailing Address - Street 1:PO BOX 163333
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32816-3333
Mailing Address - Country:US
Mailing Address - Phone:407-823-6000
Mailing Address - Fax:407-823-2099
Practice Address - Street 1:4098 LIBRA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-3333
Practice Address - Country:US
Practice Address - Phone:407-823-6000
Practice Address - Fax:407-823-2099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty