Provider Demographics
NPI:1720073737
Name:WEST ORANGE HEALTHCARE INC
Entity type:Organization
Organization Name:WEST ORANGE HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASCOE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-680-6115
Mailing Address - Street 1:PO BOX 917156
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-7156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10000 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3498
Practice Address - Country:US
Practice Address - Phone:407-296-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCI2618OtherRR MCR GROUP
FL40788OtherBCBS GROUP
FL40788OtherBCBS GROUP
FLCI2618OtherRR MCR GROUP