Provider Demographics
NPI:1154944155
Name:UNIVERSITY OF CENTRAL FLORIDA
Entity type:Organization
Organization Name:UNIVERSITY OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FOR HEALTH AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:GERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-266-1000
Mailing Address - Street 1:6850 LAKE NONA BLVD
Mailing Address - Street 2:3RD FLOOR, ATTN: LEGAL
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7408
Mailing Address - Country:US
Mailing Address - Phone:407-882-0468
Mailing Address - Fax:407-882-0483
Practice Address - Street 1:4098 LIBRA DR STE 114
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-8026
Practice Address - Country:US
Practice Address - Phone:407-823-3462
Practice Address - Fax:407-823-3464
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF CENTRAL FLORIDA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty