Organization Active NPI

River of Life Osteopathic LLC

  • Family Medicine Physician
  • Ocoee, FL
National Provider Identifier
1134426844
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS9605 Issued in FL
Legal business name
RIVER OF LIFE OSTEOPATHIC LLC
Practice address
2705 Maguire Rd
Ocoee, FL 34761-4797
Phone
(407) 574-2880
Fax
(407) 403-5612
NPI assigned
Feb 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Authorized official

Name
Dr. Ronald William Taylor Jr., D.O.NPI 1538348479
Title
Director of Operations
Phone
(407) 739-6914

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS9605 FL Primary

Addresses

Primary practice location

2705 Maguire Rd
Ocoee, FL 34761-4797

Mailing address

2705 Maguire Rd
Ocoee, FL 34761-4797
Phone (407) 574-2880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120112000346 FL Part B Supplier - Clinic/Group Practice 1658548748 Receives reassigned benefits from 6 practitioners
Practice locations: Ocoee, FL

National Provider Directory

National Provider Directory

Locations

11101 W Colonial Dr
Ocoee, FL 34761
Phone (407) 574-2880

2705 Maguire Rd
Ocoee, FL 34761
Phone (407) 574-2880

Practitioners & affiliated clinicians

Practitioners 6

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": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1134426844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 MAGUIRE RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614797",
            "telephone_number": "407-574-2880",
            "fax_number": "407-403-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 MAGUIRE RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614797",
            "telephone_number": "407-574-2880",
            "fax_number": "407-403-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER OF LIFE OSTEOPATHIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "407-739-6914",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS9605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.