NPIMap

Organization Active NPI

Plasticity Brain Centers of Orlando, LLC

  • Multi-Specialty Clinic/Center
  • Orlando, FL
National Provider Identifier
1053036616
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PLASTICITY BRAIN CENTERS OF ORLANDO, LLC
Practice address
2000 N Alafaya TRL Ste 600
Orlando, FL 32826-4741
Phone
(407) 955-4222
NPI assigned
Oct 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Angel Pope
Title
Manager of Center Support
Phone
(407) 955-4248

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

2000 N Alafaya TRL Ste 600
Orlando, FL 32826-4741

Mailing address

2000 N Alafaya TRL Ste 600
Orlando, FL 32826-4741

National Provider Directory

National Provider Directory
Tax ID family
Plasticity Brain Centers of Orlando LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2000 N Alafaya Trl
Ste 600
Orlando, FL 32826
Phone (407) 955-4222

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1053036616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N ALAFAYA TRL STE 600",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N ALAFAYA TRL STE 600",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264741",
            "telephone_number": "407-955-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTICITY BRAIN CENTERS OF ORLANDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "MANAGER OF CENTER SUPPORT",
        "authorized_official_telephone_number": "407-955-4248"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.