Riddle, Elise Fortin

Riddle, Elise Fortin is an individual health care provider with primary practice located at 1222 S Orange Ave , Orlando FL 32806-1215. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pediatric Cardiology. Allopathic & Osteopathic Physicians / Pediatric Cardiology is her primary health care specialty. Riddle, Elise Fortin can be contacted via phone (407) 649-6907.

Contact Information

Primary practice address
1222 S Orange Ave Orlando FL 32806-1215
Phone: (407) 649-6907
Fax: (407) 481-2035
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME93814 Florida
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X ME93814 Florida

Profile Details

NPI number 1861480683
LBN Legal business name Riddle, Elise Fortin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Nov 16th, 2016 - about 10 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 1861480683 NPPES
Florida MEDICAID 000064200
Florida Other ME93814

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