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Specialty details in registry · Orlando, FL

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At a glance

3226 E Colonial Dr, Orlando, FL 32803-5110

NPPES record updated Jun 28, 2013. Public records can lag behind changes at a practice.

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Practice location

3226 E Colonial Dr
Orlando, FL 32803-5110

Professional details: NPI, taxonomy & registry record

NPI1730529231

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 156FX1800X
Enumeration date: Jun 28, 2013
Record updated: Jun 28, 2013

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

156FX1800X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

3226 E Colonial Dr
Orlando, FL 32803-5110

Phone: (407) 203-5801
Fax: (407) 203-5806

Mailing address

296 GRAYSON HWY

LAWRENCEVILLE, GA 300465737

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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