NPIMap

Organization Active NPI

Experiontech, LLC

  • Surgical Physician Assistant
  • Clermont, FL
National Provider Identifier
1114403276
Registry record updated Dec 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
18324 Issued in FL
Legal business name
EXPERIONTECH, LLC
Practice address
16756 Abbey Hill CT
Clermont, FL 34711-6353
Phone
(407) 480-0295
NPI assigned
Jul 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2023

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

Authorized official

Name
Paul Lopez, SA-CNPI 1306332812
Title
Provider
Phone
(407) 480-0295

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
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X 18324 FL Primary

Addresses

Primary practice location

16756 Abbey Hill CT
Clermont, FL 34711-6353

Mailing address

16756 Abbey Hill CT
Clermont, FL 34711-6353
Phone (407) 480-0295

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702684800000",
    "number": "1114403276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16756 ABBEY HILL CT",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116353",
            "telephone_number": "407-480-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16756 ABBEY HILL CT",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116353",
            "telephone_number": "407-480-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIONTECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2023-12-16",
        "certification_date": "2023-12-16",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "407-480-0295",
        "authorized_official_credential": "SA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "18324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2023; 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.