Individual provider Active NPI

Liliana Carolina Buitrago, MD

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1144706417
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME148276 Issued in FL
Practice address
1651 N Semoran Blvd
Orlando, FL 32807-3575
Phone
(407) 249-1234
NPI assigned
Jul 19, 2018
Last updated
Jul 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Pediatrics Physician 208000000X ME148276 FL Primary

Addresses

Primary practice location

1651 N Semoran Blvd
Orlando, FL 32807-3575

Mailing address

11513 Lake Underhill Rd
Orlando, FL 32825-5001
Phone (407) 249-1234

Other practice location 1

1650 Grand Concourse
Bronx, NY 10457-7697
Phone (718) 590-1800

Other identifiers 1

IdentifierTypeStateIssuer
110616900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME148276FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Pediatrics, Inc Pediatrics CurrentSince Jul 4, 2021 Accepting new patients
First Choice Pediatrics, Inc CurrentSince Jan 2, 2022 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics Past Accepting new patients

Locations

11513 Lake Underhill Rd
Orlando, FL 32825

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1144706417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11513 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328255001",
            "telephone_number": "407-249-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 N SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073575",
            "telephone_number": "407-249-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Grand Concourse",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104577697",
            "country_code": "US",
            "telephone_number": "718-590-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUITRAGO",
        "first_name": "LILIANA",
        "middle_name": "CAROLINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME148276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110616900",
            "state": "FL"
        }
    ],
    "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 2, 2021; 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.