NPIMap

Organization Active NPI

Bridge of Hope of Central Florida Corp

  • Hearing and Speech Clinic/Center
  • Kissimmee, FL
National Provider Identifier
1104126572
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
License
SA 8292 Issued in FL
Legal business name
BRIDGE OF HOPE OF CENTRAL FLORIDA CORP
Practice address
1300 Kevstin Dr
Kissimmee, FL 34744-5843
Phone
(407) 575-4636
Fax
(321) 250-7425
NPI assigned
Nov 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Authorized official

Name
Vanessa Roman, BA
Title
C.E.O.
Phone
(407) 575-4636

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X SA 8292 FL Primary
Physical Therapy Clinic/Center 261QP2000X PT 24417 FL
Occupational Medicine Clinic/Center 261QX0100X OT 11560 FL

Addresses

Primary practice location

1300 Kevstin Dr
Kissimmee, FL 34744-5843

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
000867500MedicaidFL
000867503MedicaidFL
000867501MedicaidFL
000867502MedicaidFL

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.

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1104126572",
    "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": "1300 KEVSTIN DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445843",
            "telephone_number": "407-575-4636",
            "fax_number": "321-250-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE OF HOPE OF CENTRAL FLORIDA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "407-575-4636",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "FL",
            "license": "SA 8292",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT 24417",
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "FL",
            "license": "OT 11560",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000867500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000867503",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000867501",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000867502",
            "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 Aug 19, 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.