Florida Maxillofacial and Reconstructive Surgery PA

Primary specialty

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

Legal business name

FLORIDA MAXILLOFACIAL AND RECONSTRUCTIVE SURGERY PA

Practice address

7350 Sandlake Commons Blvd Ste 2212a
Orlando, FL 32819-8031

Phone

(407) 463-9588

Fax

(949) 798-7844

NPI assigned

Jun 3, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Terry Su, MDNPI 1205164878

Title

Owner/MD

Phone

(407) 463-9588

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terry Su, M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Orlando, FL
  • NPI 1205164878
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1669111902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1112",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347861112",
            "telephone_number": "407-463-9588",
            "fax_number": "949-798-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 SANDLAKE COMMONS BLVD STE 2212A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198031",
            "telephone_number": "407-463-9588",
            "fax_number": "949-798-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MAXILLOFACIAL AND RECONSTRUCTIVE SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-03",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "SU",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "407-463-9588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Injury & Rehabilitation
• Florida Injury East, Inc.
• Florida Institute of Research Medicine and Surgery PA (Cancer Centers of Florida)
• Florida Institute of Research, Medicine, and Surgery, P.a. (Cancer Centers of Florida)
• Florida Institute of Research, Medicine, and Surgery, P.a. (Cancer Centers of Florida)
• Florida Med Group, LLC
• Florida Med Transportation Corp
• Florida Med-Psych Consultants LLC
• Florida Medical Hearing AIDS
• Florida Medical Observation Associates, PA

• Oral & Maxillofacial Surgery (D.M.D.) in Orlando, FL
• Providers in Orlando, FL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.