Supreme Medical Group PLLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

ME109765 Issued in FL

Legal business name

SUPREME MEDICAL GROUP PLLC

Practice address

10967 Lake Under Hill Rd
Unit 137
Orlando, FL 32825-4455

Phone

(407) 930-1030

Fax

(407) 386-7277

NPI assigned

Jan 25, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Sheena Mary Jose, MDNPI 1659307759

Title

Medical Director

Phone

(407) 930-1030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Sheena Mary Jose, MD

  • Infectious Disease Physician
  • Orlando, FL
  • NPI 1659307759
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1073970810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10967 LAKE UNDER HILL ROAD",
            "address_2": "UNIT 137",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254455",
            "telephone_number": "407-930-1030",
            "fax_number": "407-386-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10967 LAKE UNDER HILL RD",
            "address_2": "UNIT 137",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254455",
            "telephone_number": "407-930-1030",
            "fax_number": "407-386-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "JOSE",
        "authorized_official_first_name": "SHEENA",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "407-930-1030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME109765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Superior Medical House Calls, Inc
• Superior Medical Transport LLC
• Suzanne J Supplee, DO
• Support Unlimited, Inc.
• Supportive Family Services, LLC
• Andrey Suprun, MD
• Sure Been Nice, Inc (A Place At Home)
• Sure Vision Centers of Florida
• Surebridge Medical
• Surgery Assistants of Orlando Inc

• Infectious Disease Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Infectious Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.