NPIMap

Organization Active NPI

Sand Lake Medical Associates, P.a.

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1104864826
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SAND LAKE MEDICAL ASSOCIATES, P.A.
Practice address
6200 Metrowest Blvd
Suite 106
Orlando, FL 32835-7636
Phone
(407) 345-1551
Fax
(407) 345-4893
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

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

Authorized official

Name
Dr. Victor Hunt Harding, M.D.
Title
Vice President
Phone
(407) 345-1551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X FL Primary

Addresses

Primary practice location

6200 Metrowest Blvd
Suite 106
Orlando, FL 32835-7636

Mailing address

6200 Metrowest Blvd
Suite 106
Orlando, FL 32835-7636
Phone (407) 345-1551

National Provider Directory

National Provider Directory

Locations

6200 Metrowest Blvd
Ste 106
Orlando, FL 32835
Phone (407) 345-1551

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1104864826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 METROWEST BLVD",
            "address_2": "SUITE 106",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328357636",
            "telephone_number": "407-345-1551",
            "fax_number": "407-345-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 METROWEST BLVD",
            "address_2": "SUITE 106",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328357636",
            "telephone_number": "407-345-1551",
            "fax_number": "407-345-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAND LAKE MEDICAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "HARDING",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "HUNT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "407-345-1551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": null,
            "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 Jul 30, 2009; 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.