Provider Demographics
NPI:1447684170
Name:ORANGE COUNTY CORRECTIONS
Entity type:Organization
Organization Name:ORANGE COUNTY CORRECTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:321-217-7950
Mailing Address - Street 1:2350 33RD STREET
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829
Mailing Address - Country:US
Mailing Address - Phone:407-254-7561
Mailing Address - Fax:407-254-8284
Practice Address - Street 1:2450 33RD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-8726
Practice Address - Country:US
Practice Address - Phone:407-254-7561
Practice Address - Fax:407-254-8284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA-9100248305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization