Provider Demographics
NPI:1841446911
Name:FIGUEROA, IAN J (MD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:J
Last Name:FIGUEROA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6675 WESTWOOD BLVD
Mailing Address - Street 2:SUITE 475
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-8061
Mailing Address - Country:US
Mailing Address - Phone:407-845-0330
Mailing Address - Fax:888-972-1752
Practice Address - Street 1:4543 PLEASANT HILL RD
Practice Address - Street 2:STE A
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3403
Practice Address - Country:US
Practice Address - Phone:407-933-7900
Practice Address - Fax:321-437-0072
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2017-02-24
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Provider Licenses
StateLicense IDTaxonomies
PR17217208D00000X
FLACN356208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004031534Medicaid
FLIG223ZMedicare Oscar/Certification