Provider Demographics
NPI:1013533975
Name:ORLANDO PHYSICIAN GROUP LLC
Entity Type:Organization
Organization Name:ORLANDO PHYSICIAN GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SADEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-718-3492
Mailing Address - Street 1:226 W MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4446
Mailing Address - Country:US
Mailing Address - Phone:407-704-8380
Mailing Address - Fax:407-930-8992
Practice Address - Street 1:222 BROADWAY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5781
Practice Address - Country:US
Practice Address - Phone:407-718-6290
Practice Address - Fax:407-930-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty