Dariusz Grzegorz Mydlarz, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME139388 Issued in FL

Practice address

6336 W Colonial Dr
Orlando, FL 32818-7812

Phone

(407) 219-5200

Fax

(321) 281-8700

NPI assigned

Nov 18, 2005

Last updated

Mar 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Madison County Community Health Centers Inc

  • Family Medicine Physician
  • Anderson, IN
  • NPI 1770668030
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1063494631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 OLD WINTER GARDEN RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328351348",
            "telephone_number": "407-751-7288",
            "fax_number": "407-770-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6336 W COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328187812",
            "telephone_number": "407-219-5200",
            "fax_number": "321-281-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYDLARZ",
        "first_name": "DARIUSZ",
        "middle_name": "GRZEGORZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101235066",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME139388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME139388",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• My Place LLC
• My Way Medi Trans LLC
• My Whole Health Life, LLC
• Mya Internal Medicine, Inc
• Deirdre Mydell
• Mye-Dash Consulting, Inc.
• Cheryl Ann Myers-Green
• Aaron Matthew Myers, MA SLP-CFY
• Alexandra Kae Myers, PA-C
• Blake Myers, CRNA

• General Practice Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.