Organization Active NPI

Central Florida Family Medical Group

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1073622247
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTRAL FLORIDA FAMILY MEDICAL GROUP
Practice address
1170 S Semoran Blvd
Suite a
Orlando, FL 32807-1458
Phone
(407) 281-9105
Fax
(407) 281-9305
NPI assigned
Aug 30, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ivan Reyes
Title
C.F.O
Phone
(407) 281-9105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X FL Primary

Addresses

Primary practice location

1170 S Semoran Blvd
Suite a
Orlando, FL 32807-1458

Mailing address

1170 S Semoran Blvd
Suite a
Orlando, FL 32807-1458
Phone (407) 281-9105

National Provider Directory

National Provider Directory

Locations

1170 S Semoran Blvd
Ste A
Orlando, FL 32807
Phone (407) 281-9105

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1073622247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 S SEMORAN BLVD",
            "address_2": "SUITE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328071458",
            "telephone_number": "407-281-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 S SEMORAN BLVD",
            "address_2": "SUITE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328071458",
            "telephone_number": "407-281-9105",
            "fax_number": "407-281-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA FAMILY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "C.F.O",
        "authorized_official_telephone_number": "407-281-9105"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "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 Jul 21, 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.