Provider Demographics
NPI:1205580990
Name:ORLANDO FAMILY PHYSICIANS, LLC
Entity type:Organization
Organization Name:ORLANDO FAMILY PHYSICIANS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SABENA
Authorized Official - Middle Name:I
Authorized Official - Last Name:CYR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-332-6947
Mailing Address - Street 1:6900 TAVISTOCK LAKES BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7592
Mailing Address - Country:US
Mailing Address - Phone:321-332-6947
Mailing Address - Fax:
Practice Address - Street 1:5051 66TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-3119
Practice Address - Country:US
Practice Address - Phone:727-800-6708
Practice Address - Fax:813-324-1133
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORLANDO FAMILY PHYSICIANS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-10
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty