Icaza, Orlando Jose

Icaza, Orlando Jose is an individual health care provider with primary practice located at 732 N 3Rd St , Leesburg FL 34748-4442. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Icaza, Orlando Jose can be contacted via phone (352) 265-8356.

Contact Information

Primary practice address
732 N 3Rd St Leesburg FL 34748-4442
Phone: (352) 265-8356
Fax: (352) 787-0854
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X ME66190 Florida

Profile Details

NPI number 1447259106
LBN Legal business name Icaza, Orlando Jose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2005
Last updated Feb 23rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447259106 NPPES
Florida MEDICAID 267636200
Florida Other 71176
Florida Other P00208162

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