Provider Demographics
NPI:1790369981
Name:OEHRLEIN, DOUGLAS ANDREW
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ANDREW
Last Name:OEHRLEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 N ORANGE AVE APT 210
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1043
Mailing Address - Country:US
Mailing Address - Phone:706-587-3318
Mailing Address - Fax:
Practice Address - Street 1:1415 SLIGHT BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:305-899-3379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN243827163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse