NPIMap

Organization Active NPI

Central Florida Pulmonary Group PA

  • Pulmonary Disease Physician
  • Orlando, FL
National Provider Identifier
1104805951
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
CENTRAL FLORIDA PULMONARY GROUP PA
Practice address
1115 E. Ridgewood St.
Orlando, FL 32803
Phone
(407) 841-1100
Fax
(407) 650-0262
NPI assigned
Jan 11, 2006
Last updated
Mar 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Jessica L. Klein
Title
Assistant Administrator
Phone
(407) 841-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X

Addresses

Primary practice location

1115 E. Ridgewood St.
Orlando, FL 32803

Mailing address

1115 E. Ridgewood St.
Orlando, FL 32803
Phone (407) 841-1100

Other identifiers 1

IdentifierTypeStateIssuer
060232900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000811 FL Part B Supplier - Clinic/Group Practice 8729983523 Receives reassigned benefits from 53 practitioners
Practice locations: Orlando, FL; Altamonte Springs, FL

National Provider Directory

National Provider Directory

Locations

10916 Dylan Loren Cir
Orlando, FL 32825
Phone (407) 385-1332

1115 E Ridgewood St
Orlando, FL 32803
Phone (407) 841-1100

326 N Mills Ave
Orlando, FL 32803
Phone (407) 841-1100

Practitioners & affiliated clinicians

Practitioners 59

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1104805951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E. RIDGEWOOD ST.",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32803",
            "telephone_number": "407-841-1100",
            "fax_number": "407-650-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E. RIDGEWOOD ST.",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32803",
            "telephone_number": "407-841-1100",
            "fax_number": "407-650-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA PULMONARY GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "407-841-1100"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060232900",
            "state": "FL"
        }
    ],
    "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 Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.