Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Florida Maxillofacial and Reconstructive Surgery PA

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1669111902

Florida Maxillofacial and Reconstructive Surgery PA is an Oral & Maxillofacial Surgery (D.M.D.) in Orlando, Florida. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7350 Sandlake Commons Blvd Ste 2212A
Orlando, FL 32819-8031
Phone: (407) 463-9588
Fax: (949) 798-7844
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X

Record details

NPI number1669111902
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Terry Su — Owner/Md · (407) 463-9588
NPI enumeratedJune 3, 2022
Last updated in NPPESFebruary 26, 2025
Certification dateFebruary 26, 2025
Mailing addressPo Box 1112, Windermere, FL 34786-1112

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