Provider Demographics
NPI:1497517155
Name:EDWARD ORSHANSKY MD INC
Entity type:Organization
Organization Name:EDWARD ORSHANSKY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ORSHANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-646-8788
Mailing Address - Street 1:12412 SAN JOSE BLVD STE 404
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8620
Mailing Address - Country:US
Mailing Address - Phone:904-464-1044
Mailing Address - Fax:904-734-6281
Practice Address - Street 1:12412 SAN JOSE BLVD STE 404
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8620
Practice Address - Country:US
Practice Address - Phone:904-464-1044
Practice Address - Fax:904-734-6281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty