Individual provider Active NPI

Dror M Peled, MD

  • Legal Medicine
  • Holiday, FL
National Provider Identifier
1073629978
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
ME0077763 Issued in FL
Practice address
5035 Mile Stretch Dr
Holiday, FL 34690-4432
Phone
(727) 944-2005
Fax
(727) 935-4879
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X ME0077763 FL Primary

Addresses

Primary practice location

5035 Mile Stretch Dr
Holiday, FL 34690-4432

Mailing address

4929 Mile Stretch Dr
Holiday, FL 34690-4348
Phone (727) 944-2005

Other identifiers 2

IdentifierTypeStateIssuer
256027500MedicaidFL
47009OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0077763FLMDLegal Medicine

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1073629978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 MILE STRETCH DR",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346904348",
            "telephone_number": "727-944-2005",
            "fax_number": "727-944-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5035 MILE STRETCH DR",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346904432",
            "telephone_number": "727-944-2005",
            "fax_number": "727-935-4879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELED",
        "first_name": "DROR",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "ME0077763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256027500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "47009",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holiday, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.