Medical Associates of Central Florida

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

ME64990 Issued in FL

Legal business name

MEDICAL ASSOCIATES OF CENTRAL FLORIDA

Practice address

1110 Druid Cir
Lake Wales, FL 33853-4307

Phone

(863) 877-2411

Fax

(863) 354-6617

NPI assigned

Jul 22, 2006

Organization subpart

Yes

Parent organization

MEDICAL ASSOCIATES OF CENTRAL FLORIDAAs reported in NPPES

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

Authorized official

Name

Dr. Mahesh Gandhi Allam, MDNPI 1124188180

Title

President

Phone

(863) 877-2411

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Medical Associates of Central Florida2 organizations share this tax ID, including this one

Part of

Medical Associates of Central Florida

Other organizations with this tax ID 1

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

• Medical Associates of Central Florida

  • Family Nurse Practitioner
  • Haines City, FL
  • NPI 1235432543
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ABCBDD

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mahesh Gandhi Allam, M.D.

  • Internal Medicine Physician
  • Lake Wales, FL
  • NPI 1124188180

  Pulmonary Disease

  Medicare reassignment NPD Authorized official
• Nakisha Lavon Watson, APRN

  • Family Nurse Practitioner
  • Lakeland, FL
  • NPI 1659884096
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1124049317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 DRUID CIR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534307",
            "telephone_number": "863-877-2411",
            "fax_number": "863-354-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 DRUID CIR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534307",
            "telephone_number": "863-877-2411",
            "fax_number": "863-354-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF CENTRAL FLORIDA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL ASSOCIATES OF CENTRAL FLORIDA",
        "enumeration_date": "2006-07-22",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "ALLAM",
        "authorized_official_first_name": "MAHESH",
        "authorized_official_middle_name": "GANDHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-877-2411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME64990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "23488",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP IDENTIFIER",
            "identifier": "45617",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CH8733",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263360400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McKeon Chiropractic Clinic PA
• Mark John McKeon, D.C.
• Thomas Daniel McKeon Jr., D.C.
• Twascha Rena McKnight
• Marilyn McNeil, LPN
• Medical Associates of Central Florida Physicians, LLC
• Medical Home Alliance LLC
• Medical Imaging Experts of Central Florida, LLC
• Michelle Lora Mendez
• Mental Oasis LLC

• Pulmonary Disease Physician in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Pulmonary Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.