Individual provider Active NPI

Sula Mazimba, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Orlando, FL
National Provider Identifier
1023000809
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
ME161996 Issued in FL
Practice address
2415 N Orange Ave Ste 700
Orlando, FL 32804-5521
Phone
(407) 303-2474
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 0101256847 VA
Internal Medicine Physician 207R00000X 35085788M OH
Cardiovascular Disease Physician 207RC0000X 0101256847 VA
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X ME161996 FL Primary

Addresses

Primary practice location

2415 N Orange Ave Ste 700
Orlando, FL 32804-5521

Mailing address

2415 N Orange Ave Ste 700
Orlando, FL 32804-5521
Phone (407) 303-2474

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0001
Phone (434) 982-4247

Other practice location 2

1221 Lee St
Charlottesville, VA 22908-0001
Phone (434) 243-1000

Other identifiers 1

IdentifierTypeStateIssuer
2569377MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230718003345 FL Practitioner - Cardiovascular Disease (Cardiology) 6406884659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050

2415 N Orange Ave
Orlando, FL 32804-5505

2415 N Orange Ave
Suite 700
Orlando, FL 32804-5521
Phone (407) 303-2474

2501 N Orange Ave
Orlando, FL 32804-4641

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35085788MOHMDInternal Medicine Physician
ME161996FLMDAdvanced Heart Failure and Transplant Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Aug 28, 2023 Accepting new patients
Florida Hospital Medical Group Inc Internal Medicine CurrentSince Aug 28, 2023 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

265 E Rollins St
Ste 5300
Orlando, FL 32804
Phone (407) 539-2766

2415 N Orange Ave
Ste 700
Orlando, FL 32804
Phone (407) 303-2474

Networks

  • Optimum HealthCare HMO Network
  • FL PPO
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: smazimba1593838@adventhealth.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1023000809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 700",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045521",
            "telephone_number": "407-303-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 700",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045521",
            "telephone_number": "407-303-2474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080001",
            "country_code": "US",
            "telephone_number": "434-982-4247",
            "fax_number": "434-982-1998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080001",
            "country_code": "US",
            "telephone_number": "434-243-1000",
            "fax_number": "434-244-7551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZIMBA",
        "first_name": "SULA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "VA",
            "license": "0101256847",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35085788M",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101256847",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "FL",
            "license": "ME161996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2569377",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.