Provider Demographics
NPI:1942483805
Name:ORLANDO HEALTH NETWORK INC
Entity Type:Organization
Organization Name:ORLANDO HEALTH NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:EGGERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-841-5111
Mailing Address - Street 1:521 W. STATE RD. 434
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750
Mailing Address - Country:US
Mailing Address - Phone:407-767-5808
Mailing Address - Fax:407-767-5892
Practice Address - Street 1:521 W. STATE RD. 434
Practice Address - Street 2:SUITE 100
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750
Practice Address - Country:US
Practice Address - Phone:407-767-5808
Practice Address - Fax:407-767-5892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33078GMedicare PIN
FL33078KMedicare PIN