| Organization Name: | EAST ORLANDO PRIMARY CARE P A |
| NPI Number: | 1629223227 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIE M FERNANDEZ (PRESIDENT) |
| Mailing Address: | 733 S. Goldenrod Rd Suite B Orlando |
| State: | FL US |
| Postal Code: | 32822 |
| Phone Number: | 4072497999 |
| Fax Number: | 4072490309 |
| NPI Enumeration Date: | 11/24/2008 |
| NPI Last Update Date: | 01/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OS 7959 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |