Provider Demographics
NPI:1588680466
Name:ORLANDO ULTRASOUND ASSOCIATES INC
Entity type:Organization
Organization Name:ORLANDO ULTRASOUND ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SNIDER
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS RDCS RVT
Authorized Official - Phone:407-273-7303
Mailing Address - Street 1:11325 LAKE UNDERHILL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825
Mailing Address - Country:US
Mailing Address - Phone:407-273-7303
Mailing Address - Fax:407-381-2502
Practice Address - Street 1:11325 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825
Practice Address - Country:US
Practice Address - Phone:407-273-7303
Practice Address - Fax:407-381-2502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC49522085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E9123Medicare ID - Type Unspecified