Ucfaa

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

AL 3863 Issued in FL

Legal business name

UCFAA

Practice address

4000 Central Florida Blvd RM 102
Orlando, FL 32816-8005

Phone

(407) 823-2030

NPI assigned

Jan 10, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Mary Vander Heiden

Title

Director of Sports Medicine

Phone

(407) 823-2030

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452384000000",
    "number": "1134585987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 CENTRAL FLORIDA BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328168005",
            "telephone_number": "708-228-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CENTRAL FLORIDA BLVD RM 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328168005",
            "telephone_number": "407-823-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCFAA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-10",
        "last_updated": "2016-01-10",
        "status": "A",
        "authorized_official_last_name": "VANDER HEIDEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF SPORTS MEDICINE",
        "authorized_official_telephone_number": "407-823-2030",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "FL",
            "license": "AL 3863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Orlando, FL
• Providers in Orlando, FL by specialty
• Point of Service in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2016; 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.