Provider Demographics
NPI:1134236219
Name:OSTEOPOROSIS CENTERS OF AMERICA INC
Entity type:Organization
Organization Name:OSTEOPOROSIS CENTERS OF AMERICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELBA
Authorized Official - Middle Name:IRIS
Authorized Official - Last Name:OVALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-877-4075
Mailing Address - Street 1:PO BOX 1466
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786
Mailing Address - Country:US
Mailing Address - Phone:407-877-4075
Mailing Address - Fax:407-877-8495
Practice Address - Street 1:1002 SOUTH DILLARD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787
Practice Address - Country:US
Practice Address - Phone:407-877-4075
Practice Address - Fax:407-877-8495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64514261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64112OtherBCBS
FL64112OtherBCBS