NPIMap

Organization Active NPI

Avalon Park Family Medicine

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1093977167
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS5964 Issued in FL
Legal business name
AVALON PARK FAMILY MEDICINE
Practice address
13000 Avalon Lake Dr
Ste 100
Orlando, FL 32828-6448
Phone
(407) 380-7966
Fax
(407) 380-7988
NPI assigned
Jun 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Authorized official

Name
Dr. George M Hudson, DONPI 1124008388
Title
Owner
Phone
(407) 380-7966

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS5964 FL Primary

Addresses

Primary practice location

13000 Avalon Lake Dr
Ste 100
Orlando, FL 32828-6448

Mailing address

13000 Avalon Lake Dr
Ste 100
Orlando, FL 32828-6448
Phone (321) 235-0967

National Provider Directory

National Provider Directory
Tax ID family
Avalon Park Family Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1093977167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 AVALON LAKE DR",
            "address_2": "STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286448",
            "telephone_number": "321-235-0967",
            "fax_number": "321-235-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 AVALON LAKE DR",
            "address_2": "STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286448",
            "telephone_number": "407-380-7966",
            "fax_number": "407-380-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON PARK FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-380-7966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.