Provider Demographics
NPI:1801843263
Name:NORTH ORLANDO SURGICAL GROUP, INC
Entity Type:Organization
Organization Name:NORTH ORLANDO SURGICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEINBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-775-0333
Mailing Address - Street 1:1061 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8200
Mailing Address - Country:US
Mailing Address - Phone:386-775-0333
Mailing Address - Fax:386-775-0427
Practice Address - Street 1:1061 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 305
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8200
Practice Address - Country:US
Practice Address - Phone:386-775-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2626230OtherAETNA
FL34654OtherBCBS
FL34654OtherBCBS