Active NPI 1104913110 Individual Practitioner Male Practitioner

Dr. Robert Joseph Feezor , MD

Surgery - Vascular Surgery • Gainesville, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Robert Feezor, MD is a certified Surgery - Vascular Surgery practicing in Gainesville, FL. With approximately 27 years of clinical experience since completing medical education in 1999, Dr. Feezor delivers high-quality medical care to the local community at 1600 SW ARCHER RD.

Dr. Feezor is affiliated with Florida Clinical Practice Association Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, complete ultrasound study of arm and leg arteries, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1600 Sw Archer Rd

Gainesville, FL 326103003

Telephone 3522735484

Fax 3522735515

Associated Practice Facility / Clinic

🏢 Faculty Associates, Inc Facility NPI 1659322014

Medicare Profile & Education

Medical School

Other

Graduation Year

1999

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Vascular Surgery in Gainesville, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

27 Yrs +2.8 yrs vs City Avg

City Avg: 24.2 Yrs

State Avg: 27.2 Yrs

Regional Practice Density

17 Specialists

Practicing in Gainesville, FL (412 Statewide)

Telehealth Adoption Rate

17.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

81.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Feezor (27 Years) 27 Yrs

Gainesville Specialty Average (24.2 Years) 24.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	359	261	$333.63	$88.23
93923 Complete ultrasound study of arm and leg arteries	230	185	$676.58	$112.56
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	144	108	$469.96	$123.96
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	134	108	$60.09	$16.09
93880 Ultrasound of both sides of head and neck blood flow	128	117	$1015.25	$171.97
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	82	82	$616.56	$163.42
76937 Ultrasonic guidance for blood vessel access	57	49	$81.98	$13.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	42	42	$412.50	$108.75
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	32	28	$483.16	$82.11
75625 Radiological supervision and interpretation X-ray of abdominal aorta	28	26	$396.71	$67.61
93926 Ultrasound of one leg arteries or artery grafts	28	20	$713.86	$121.34
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	25	25	$485.40	$128.26
93990 Ultrasound of dialysis access	23	18	$664.52	$113.74
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	15	15	$808.60	$215.26
93970 Ultrasound study of arm or leg veins with compression and maneuvers	15	15	$981.33	$166.20
99221 Initial hospital inpatient care per day, typically 30 minutes	14	14	$311.50	$81.81
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	14	14	$1000.14	$158.55
36246 Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch	14	12	$2555.43	$245.29
34713 Exposure of one groin artery for delivery of graft, accessed through the skin	11	11	$806.64	$136.76
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	11	11	$659.00	$176.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	243	183	$325.94	$88.29
93923 Complete ultrasound study of arm and leg arteries	159	119	$694.99	$119.36
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	156	124	$457.59	$125.23
93880 Ultrasound of both sides of head and neck blood flow	97	84	$1041.06	$181.61
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	70	70	$603.89	$164.70
76937 Ultrasonic guidance for blood vessel access	48	44	$79.63	$14.50
75625 Radiological supervision and interpretation X-ray of abdominal aorta	30	27	$392.00	$68.44
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	29	25	$477.90	$83.73
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	26	26	$794.69	$217.98
99221 Initial hospital inpatient care per day, typically 30 minutes	26	26	$329.77	$83.79
93926 Ultrasound of one leg arteries or artery grafts	22	18	$705.73	$122.60
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	21	21	$482.43	$130.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$408.74	$110.89
93990 Ultrasound of dialysis access	19	17	$713.68	$123.99
93922 Ultrasound study of arm and leg arteries	19	19	$446.79	$77.60
37215 Insertion of stent and blood clot protection device in neck artery with review by radiologist	18	17	$5843.33	$976.69
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	15	14	$654.33	$108.36
93970 Ultrasound study of arm or leg veins with compression and maneuvers	14	14	$971.64	$165.83
36832 Revision of dialysis graft, open procedure	13	11	$4392.38	$769.18
36246 Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch	11	11	$2478.82	$245.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93923 Complete ultrasound study of arm and leg arteries	236	165	$705.22	$123.75
99213 Established patient office or other outpatient visit, typically 15 minutes	220	174	$323.50	$89.75
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	185	135	$457.08	$126.79
93880 Ultrasound of both sides of head and neck blood flow	103	84	$1049.57	$185.08
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	92	92	$597.97	$167.24
76937 Ultrasonic guidance for blood vessel access	57	48	$77.00	$13.83
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	51	51	$793.00	$221.12
99221 Initial hospital inpatient care per day, typically 30 minutes	38	37	$363.37	$101.00
75625 Radiological supervision and interpretation X-ray of abdominal aorta	37	35	$393.57	$70.78
99231 Follow-up hospital inpatient care per day, typically 15 minutes	37	25	$138.08	$38.81
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	36	30	$479.33	$85.92
93926 Ultrasound of one leg arteries or artery grafts	35	22	$703.29	$126.97
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	34	34	$254.76	$70.86
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	26	22	$656.69	$117.48
93970 Ultrasound study of arm or leg veins with compression and maneuvers	24	24	$1000.17	$178.42
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	23	21	$644.48	$179.35
36246 Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch	18	17	$2437.00	$257.04
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	17	17	$1004.06	$174.88
93990 Ultrasound of dialysis access	17	13	$709.94	$129.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	14	$199.60	$56.07
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	14	12	$1474.50	$262.09
37224 Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure	12	11	$8383.58	$361.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93923 Complete ultrasound study of arm and leg arteries	229	153	$703.48	$125.60
99213 Established patient office or other outpatient visit, typically 15 minutes	204	159	$293.58	$91.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	153	119	$421.83	$129.70
93880 Ultrasound of both sides of head and neck blood flow	87	72	$1061.11	$192.53
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	82	82	$589.24	$169.08
76937 Ultrasonic guidance for blood vessel access	42	34	$79.29	$14.09
93926 Ultrasound of one leg arteries or artery grafts	38	20	$704.00	$125.31
99231 Follow-up hospital inpatient care per day, typically 15 minutes	38	24	$138.66	$38.52
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	34	34	$766.09	$223.49
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	31	31	$256.65	$72.18
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	29	21	$647.97	$116.73
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	28	27	$172.29	$55.76
99221 Initial hospital inpatient care per day, typically 30 minutes	26	26	$365.23	$102.57
93970 Ultrasound study of arm or leg veins with compression and maneuvers	23	21	$1036.00	$190.77
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	20	13	$1472.20	$271.42
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	18	18	$1010.89	$176.29
93990 Ultrasound of dialysis access	17	12	$713.47	$128.46
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	15	12	$485.20	$87.48
75625 Radiological supervision and interpretation X-ray of abdominal aorta	15	13	$395.33	$71.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$393.73	$112.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	230	174	$257.22	$75.35
93923 Complete ultrasound study of arm and leg arteries	214	142	$695.36	$127.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	90	76	$372.92	$109.19
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	79	79	$570.10	$166.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	74	60	$156.66	$45.48
93880 Ultrasound of both sides of head and neck blood flow	69	63	$1048.13	$195.44
76937 Ultrasonic guidance for blood vessel access	50	39	$79.04	$14.90
99221 Initial hospital inpatient care per day, typically 30 minutes	43	40	$383.44	$104.90
93970 Ultrasound study of arm or leg veins with compression and maneuvers	32	31	$1022.25	$191.23
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	28	25	$254.25	$73.82
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	28	25	$630.50	$117.07
75625 Radiological supervision and interpretation X-ray of abdominal aorta	27	25	$349.85	$73.54
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	27	22	$480.44	$90.36
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$373.88	$108.51
99231 Follow-up hospital inpatient care per day, typically 15 minutes	23	15	$137.39	$40.26
36246 Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch	19	16	$2334.63	$275.58
93990 Ultrasound of dialysis access	18	16	$712.33	$133.24
93926 Ultrasound of one leg arteries or artery grafts	18	14	$705.11	$132.27
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	16	16	$721.88	$210.73
36821 Relocation of arm vein with connection to arm artery, open procedure	16	16	$3851.75	$723.15
36832 Revision of dialysis graft, open procedure	14	13	$4306.29	$780.51
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	11	11	$989.91	$185.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93923 Complete ultrasound study of arm and leg arteries	232	152	$699.79	$127.97
99213 Established patient office or other outpatient visit, typically 15 minutes	225	161	$249.03	$73.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	86	78	$365.98	$107.00
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	74	63	$149.95	$44.36
99221 Initial hospital inpatient care per day, typically 30 minutes	72	70	$393.00	$103.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	72	72	$561.00	$163.23
93880 Ultrasound of both sides of head and neck blood flow	61	51	$1055.28	$195.30
75625 Radiological supervision and interpretation X-ray of abdominal aorta	37	32	$307.43	$57.70
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	35	30	$475.54	$89.48
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	35	22	$250.43	$73.53
93926 Ultrasound of one leg arteries or artery grafts	30	20	$702.67	$130.92
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	25	21	$627.80	$111.18
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	22	22	$368.00	$108.17
93970 Ultrasound study of arm or leg veins with compression and maneuvers	21	21	$1018.86	$190.07
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	18	18	$706.83	$207.23
36246 Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch	16	15	$2306.63	$273.93
76937 Ultrasonic guidance for blood vessel access	16	15	$78.00	$14.75
35301 Removal of blood clot and portion of artery of neck	16	14	$6516.81	$1222.47
93990 Ultrasound of dialysis access	13	11	$709.31	$132.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93923 Complete ultrasound study of arm and leg arteries	256	169	$701.47	$126.92
99213 Established patient office or other outpatient visit, typically 15 minutes	135	108	$249.47	$72.19
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	129	107	$147.43	$43.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	128	102	$364.45	$106.52
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	81	81	$559.88	$164.24
93880 Ultrasound of both sides of head and neck blood flow	70	62	$1043.56	$193.15
93990 Ultrasound of dialysis access	49	32	$709.57	$133.30
93970 Ultrasound study of arm or leg veins with compression and maneuvers	39	39	$1023.44	$191.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	34	34	$368.68	$107.63
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	31	31	$706.71	$206.85
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	29	25	$359.83	$88.62
75625 Radiological supervision and interpretation X-ray of abdominal aorta	29	26	$306.90	$57.57
99221 Initial hospital inpatient care per day, typically 30 minutes	26	25	$390.31	$102.84
93926 Ultrasound of one leg arteries or artery grafts	25	18	$683.16	$127.84
36832 Revision of dialysis graft, open procedure	25	23	$4343.40	$790.25
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	21	17	$624.81	$110.74
36830 Connection of tube graft to vein and artery for dialysis	16	13	$3793.19	$684.63
36246 Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch	14	14	$2259.29	$252.79
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	14	11	$250.57	$73.36
36821 Relocation of arm vein with connection to arm artery, open procedure	14	14	$3811.86	$685.94
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	11	11	$569.09	$138.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93923 Complete ultrasound study of arm and leg arteries	159	129	$713.75	$129.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	96	77	$149.50	$42.83
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	60	60	$409.27	$107.26
99202 New patient office or other outpatient visit, typically 20 minutes	57	57	$291.65	$73.76
93880 Ultrasound of both sides of head and neck blood flow	56	42	$1011.55	$190.46
93926 Ultrasound of one leg arteries or artery grafts	55	37	$752.73	$128.99
99213 Established patient office or other outpatient visit, typically 15 minutes	55	48	$264.64	$72.02
93990 Ultrasound of dialysis access	45	25	$628.62	$129.47
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	39	32	$308.49	$57.53
93970 Ultrasound study of arm or leg veins with compression and maneuvers	37	35	$989.22	$189.56
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	36	28	$626.83	$107.74
75625 Radiological supervision and interpretation X-ray of abdominal aorta	26	23	$305.42	$57.20
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	17	14	$1281.76	$271.48
37224 Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure	16	12	$7717.88	$417.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	14	12	$399.29	$105.97
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$566.93	$163.05
36200 Insertion of catheter into aorta	11	11	$1508.18	$119.58
36832 Revision of dialysis graft, open procedure	11	11	$4359.73	$811.30

Medical Specialties & State Licenses

Surgery - Vascular Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0129X

State License FL ME85876

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Surgery

NUCC Taxonomy Code: 208600000X

State License FL ME85876

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

000043800 (FL)

Hospital & Practice Group Affiliations

Florida Clinical Practice Association Inc

1600 Sw Archer Rd, Gainesville, FL 326103003

Florida Clinical Practice Association Inc

1600 Sw Archer, Gainesville, FL 326103003

Florida Clinical Practice Association Inc

3400 E Halifax Crossing Blvd, Deltona, FL 327252914

Phone: 3862411100

Florida Clinical Practice Association Inc

311 N Clyde Morris Blvd, Daytona Beach, FL 321142781

Florida Clinical Practice Association Inc

303 N Clyde Morris Blvd, Daytona Beach, FL 321142709

Phone: 3864254000

Florida Clinical Practice Association Inc

1600 Sw Archer Rd Rm, Gainesville, FL 326103003

Phone: 3522650535

Florida Clinical Practice Association Inc

Uf Health Test Site Pop Up 1600 Sw Ar, Gainesville, FL 326103003

Phone: 3523921161

Florida Clinical Practice Association Inc

2001 Sw 13th St, Gainesville, FL 326081532

Phone: 3522658982

Florida Clinical Practice Association Inc

1600 Sw Archer Rd, Gainesville, FL 326103003

Florida Clinical Practice Association Inc

3300 E Halifax Crossing Blvd, Deltona, FL 327252911

Phone: 3864254000

Florida Clinical Practice Association Inc

2001 Sw 13th St, Gainesville, FL 326081532

Phone: 3522658990

Florida Clinical Practice Association Inc

2000 Sw Archer Rd, Gainesville, FL 326103003

Phone: 3522658250

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

16 Associated Practitioners

Dr. Samir Shah , MD

Surgery - Vascular Surgery

NPI 1013180553

Doctor of Medicine (M.D.)

Mary Christie , ARNP

Nurse Practitioner

NPI 1023143187

Advanced Registered Nurse Practitioner

Dr. Thomas Beaver , MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

NPI 1043255607

Doctor of Medicine (M.D.)

Jonathan Carroll , PA-C

Physician Assistant

NPI 1093115818

Physician Assistant (Certified)

Dr. Thomas Huber , MD, PhD

Surgery - Vascular Surgery

NPI 1154362176

Doctor of Medicine (M.D.), Doctor of Philosophy (Ph.D.)

Carolyn Rollins , ARNP

Nurse Practitioner - Adult Health

NPI 1154673606

Advanced Registered Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active November 28, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location November 28, 2011

Registered at 1600 SW ARCHER RD, GAINESVILLE, FL 326103003 (Tel: 3522735484)

📍

Updated Business Mailing Address November 28, 2011

Registered at PO BOX 918025, ORLANDO, FL 328918025 (Tel: 3522735484)

👤

Provider Name / Credentials Updated November 28, 2011

Recorded as ROBERT FEEZOR, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 28, 2011

Surgery (License #ME85876 in FL)

🟢

Initial NPI Registration & Enumeration October 10, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1104913110

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 10, 2006

Last Update: November 28, 2011

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 918025

Orlando, FL 328918025

Phone: 3522735484

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.