Provider Demographics
NPI:1851848238
Name:EAR NOSE THROAT & SINUS CENTER OF ORLANDO PA
Entity Type:Organization
Organization Name:EAR NOSE THROAT & SINUS CENTER OF ORLANDO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-937-1031
Mailing Address - Street 1:2828 CASA ALOMA WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2272
Mailing Address - Country:US
Mailing Address - Phone:407-937-1031
Mailing Address - Fax:407-678-0627
Practice Address - Street 1:2828 CASA ALOMA WAY
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2223
Practice Address - Country:US
Practice Address - Phone:407-937-1031
Practice Address - Fax:407-678-0627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-02
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty