Provider Demographics
NPI:1215505508
Name:NEMOURS CHILDREN'S HEALTH, DOWNTOWN ORLANDO, SPECIALTY CARE
Entity type:Organization
Organization Name:NEMOURS CHILDREN'S HEALTH, DOWNTOWN ORLANDO, SPECIALTY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:MCKENDREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-697-5648
Mailing Address - Street 1:10140 CENTURION PKWY N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1717 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2944
Practice Address - Country:US
Practice Address - Phone:407-650-7715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE NEMOURS FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty