Provider Demographics
NPI:1912949546
Name:PHILIP REID ORANBURG MD PA
Entity Type:Organization
Organization Name:PHILIP REID ORANBURG MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:R
Authorized Official - Last Name:ORANBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-391-5800
Mailing Address - Street 1:1590 NW 10TH AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1313
Mailing Address - Country:US
Mailing Address - Phone:561-391-5800
Mailing Address - Fax:561-338-9251
Practice Address - Street 1:1590 NW 10TH AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1313
Practice Address - Country:US
Practice Address - Phone:561-391-5800
Practice Address - Fax:561-338-9251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 41520207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00315Medicare ID - Type Unspecified