Provider Demographics
NPI:1992399034
Name:ORANGE COUNTY BOARD OF COUNTY COMMISSIONERS
Entity Type:Organization
Organization Name:ORANGE COUNTY BOARD OF COUNTY COMMISSIONERS
Other - Org Name:ORANGE COUNTY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORANGE COUNTY HEALTH SERVICES DIREC
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:407-836-9215
Mailing Address - Street 1:101 S WESTMORELAND DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-2258
Mailing Address - Country:US
Mailing Address - Phone:407-836-7100
Mailing Address - Fax:321-321-8193
Practice Address - Street 1:101 S WESTMORELAND DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-2258
Practice Address - Country:US
Practice Address - Phone:407-836-7100
Practice Address - Fax:321-321-8193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty