Organization Active NPI

Bridge of Hope Central Florida Corp

  • Speech-Language Pathologist
  • Kissimmee, FL
National Provider Identifier
1093160962
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA13797 Issued in FL
Legal business name
BRIDGE OF HOPE CENTRAL FLORIDA CORP
Practice address
1068 Cypress Pkwy
Kissimmee, FL 34759-3328
Phone
(407) 575-4636
Fax
(407) 343-5599
NPI assigned
Apr 28, 2016
Last updated
May 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Authorized official

Name
Mr. Hector L Rodriguez, AB
Title
President
Phone
(407) 575-4636

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT6408 FL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT15384 FL
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SA13797 FL Primary

Addresses

Primary practice location

1068 Cypress Pkwy
Kissimmee, FL 34759-3328

Mailing address

PO Box 452878
Kissimmee, FL 34745-2878
Phone (407) 575-4636

Other identifiers 2

IdentifierTypeStateIssuer
000867505MedicaidFL
000867503MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Bridge of Hope Central Florida Corp8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1068 Cypress Pkwy
Kissimmee, FL 34759

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1093160962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452878",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347452878",
            "telephone_number": "407-575-4636",
            "fax_number": "407-343-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 CYPRESS PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593328",
            "telephone_number": "407-575-4636",
            "fax_number": "407-343-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE OF HOPE CENTRAL FLORIDA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-575-4636",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "AB"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT6408",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT15384",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA13797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000867505",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000867503",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.