INSTITUTE FOR THE TREATMENT OF CRANIOFACIAL PAIN, PA (NPI# 1952866600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952866600 |
Entity Type | Organization |
Organization Name | INSTITUTE FOR THE TREATMENT OF CRANIOFACIAL PAIN, PA |
Practice Address |
2122 E Robinson St Orlando FL 32803-6047 |
Mailing Address |
1203 Preserve Point Dr Winter Park FL 32789-5939 |
Practice Telephone | 4079630553 |
Practice Fax Number | 4076375183 |
Mailing Telephone | 4079630553 |
Enumeration Date | 2019-02-07 |
Last Update Date | 2019-07-16 |
Authorized Official Name | DR. BRIAN D. FUSELIER (OWNER) |
Authorized Official Telephone | 4079630553 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | OMS | 1265405518 | 01 |
FL | OMS | 1700859063 | 01 |
Street Address |
2122 E ROBINSON ST |
City | ORLANDO |
State | FL |
Zip Code | 32803-6047 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528118916 | Joseph Michael Bongiorno II | Dentist | 2122 E Robinson St, Orlando, FL 32803-6047 | 2007-01-10 |
1295208460 | Center for Dental Anesthesia Pa | Dentist | 2122 E Robinson St, Orlando, FL 32803-6047 | 2019-01-09 |
1073929568 | Kyle Duffy | Dentist | 2122 E Robinson St, Orlando, FL 32803-6047 | 2014-07-07 |
1447306386 | Lawrence Duffy | Dentist | 2122 E Robinson St, Orlando, FL 32803-6047 | 2007-01-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255952636 | Laiza Souza Tanner | Technician | 500 E Rollins St, Orlando, FL 32803 | 2020-04-27 |
1407415342 | Betty Carrol | Marriage & Family Therapist | 1516 E Colonial Dr Ste 100, Orlando, FL 32803 | 2019-06-12 |
1326606047 | Anthony Balingit | Physical Therapy Assistant | 1870 Aloma Avenue, Orlando, FL 32803 | 2019-05-29 |
1396234795 | Natasha Le Morvan | Technician/Technologist | 1364 Ferris Ave, Orlando, FL 32803 | 2018-05-02 |
1306365796 | Sarah E Fischer | Nurse Practitioner | Adventhealth Orlando, 601 E Rollins St, Orlando, FL 32803 | 2017-09-17 |
1710404249 | Emilia's Direct Care Agency | Community/Behavioral Health | 3218 E Colonial Dr Rm 118, Orlando, FL 32803 | 2017-08-25 |
1760907620 | Kalie Brianne Morris | Speech-Language Pathologist | 1120 Portland Ave Unit 7, Orlando, FL 32803 | 2017-08-11 |
1972024271 | Tatiana Ungredda | Psychologist | 5201 Raymond St Ste 424, Orlando, FL 32803 | 2017-06-28 |
1063942662 | Michael Thomas | Licensed Practical Nurse | 101 South Bumby Ave, E11, Orlando, FL 32803 | 2017-06-15 |
1598209249 | Danielle Marin | Behavioral Analyst | 2807 Edgewater Dr, Orlando, FL 32803 | 2016-12-15 |
Find all providers in zip 32803 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154838365 | Trevisani Oral Surgery Orlando Plc | Dentist | 10967 Lake Underhill Rd Ste 144, Orlando, FL 32825-4456 | 2018-01-09 |
1598021016 | Jonathan Clinton Elmore | Dentist | 688 N Alafaya Trl Ste 107, Orlando, FL 32828-4355 | 2012-04-10 |
1700053881 | Oral & Maxillofacial Surgeons of Mid-florida, Pa | Dentist | 1100 Lucerne Ter, Suite 100, Orlando, FL 32806-1050 | 2008-05-08 |
1871768978 | Frankie Miguel Gomez | Dentist | 610 N Mills Ave Ste 100, Orlando, FL 32803-7103 | 2008-04-29 |
1952427395 | Douglas Kent Powelson | Dentist | 7651 Ashley Park Ct, Suite #406, Orlando, FL 32835-6114 | 2007-03-21 |
1497798433 | Carlos M Alvarez | Dentist | 420 E Church St Unit 905, Orlando, FL 32801 | 2006-06-14 |
1114987831 | Ramon L Ruiz | Dentist | 207 W Gore St Ste 302, Orlando, FL 32806-1014 | 2006-03-25 |
1114990470 | Wilbur M Davis Jr. | Dentist | 610 N Mills Ave, Ste 100, Orlando, FL 32803-7119 | 2006-02-08 |
1265405518 | Barry A Loughner | Dentist | 610 North Mills Ave, Ste 100, Orlando, FL 32803 | 2006-02-08 |
1750933545 | Premier Oral & Facial Surgery | Dentist | 13571 Narcoossee Road, Orlando, FL 32832-6952 | 2019-07-11 |
Find all providers in ORLANDO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.