Organization Active NPI

Altamonte Primary Care, Inc

  • Family Medicine Physician
  • Apopka, FL
National Provider Identifier
1083774178
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME038388 Issued in FL
Legal business name
ALTAMONTE PRIMARY CARE, INC
Practice address
1706 E Semoran Blvd
Suite 115
Apopka, FL 32703-5651
Phone
(407) 889-0007
Fax
(407) 889-5557
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Susan Rhea
Title
Office Manager
Phone
(407) 889-0007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME038388 FL Primary

Addresses

Primary practice location

1706 E Semoran Blvd
Suite 115
Apopka, FL 32703-5651

Mailing address

1706 E Semoran Blvd
Apopka, FL 32703-5651

Other identifiers 1

IdentifierTypeStateIssuer
257631700MedicaidFL

National Provider Directory

National Provider Directory

Locations

1706 E Semoran Blvd
Ste 115
Apopka, FL 32703
Phone (407) 889-0007

1706 E Semoran Blvd
Apopka, FL 32703
Phone (407) 267-7374

1101 E Colonial Dr
Orlando, FL 32803
Phone (407) 647-6000

221 S Knowles Ave
Winter Park, FL 32789

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1083774178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 E SEMORAN BLVD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 E SEMORAN BLVD",
            "address_2": "SUITE 115",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035651",
            "telephone_number": "407-889-0007",
            "fax_number": "407-889-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMONTE PRIMARY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "RHEA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-889-0007"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME038388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257631700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.