Athena Health Care Center Inc

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

ME115832 Issued in FL

Legal business name

ATHENA HEALTH CARE CENTER INC

Practice address

4240 Lakeland Highlands Rd
Lakeland, FL 33813-3113

Phone

(863) 646-8699

NPI assigned

Jan 27, 2015

Organization subpart

No

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

Authorized official

Name

Amaury Guerra Gutierrez, M.D.

Title

President

Phone

(305) 742-5026

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1083004287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 VINTAGE VIEW BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338125067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 LAKELAND HIGHLANDS RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133113",
            "telephone_number": "863-646-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA HEALTH CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "GUERRA GUTIERREZ",
        "authorized_official_first_name": "AMAURY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-742-5026",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME115832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Geriatric Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.