Provider Demographics
NPI:1952449209
Name:OB GYN OF CENTRAL FLORIDA, PA
Entity Type:Organization
Organization Name:OB GYN OF CENTRAL FLORIDA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ORREGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-298-4910
Mailing Address - Street 1:10131 W COLONIAL DR
Mailing Address - Street 2:SUITE #4
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4221
Mailing Address - Country:US
Mailing Address - Phone:407-298-4910
Mailing Address - Fax:407-296-2638
Practice Address - Street 1:10131 W COLONIAL DR
Practice Address - Street 2:SUITE #4
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4221
Practice Address - Country:US
Practice Address - Phone:407-298-4910
Practice Address - Fax:407-296-2638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 84663207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH69356Medicare UPIN