Origins Functional Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS13606 Issued in FL

Legal business name

ORIGINS FUNCTIONAL MEDICINE, LLC

Practice address

260 Lookout PL Ste 106
Maitland, FL 32751-4485

Phone

(407) 902-1942

NPI assigned

Mar 1, 2016

Last updated

Mar 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Linda Matteoli, DONPI 1649568320

Title

Owner

Phone

(407) 902-4912

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Linda Marie Matteoli, D.O,

  • Family Medicine Physician
  • Longwood, FL
  • NPI 1649568320
  Authorized official Same address or phone

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

{
    "created_epoch": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1164882437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 LOOKOUT PL STE 106",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514485",
            "telephone_number": "407-902-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 LOOKOUT PL STE 106",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514485",
            "telephone_number": "407-902-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORIGINS FUNCTIONAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "MATTEOLI",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-902-4912",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Gabriel Oliver
• Pedro T. Oliveros Jr., MD
• Katherine Olsen, LMHC
• Op Pharmacy LLC (OnePoint Patient Care)
• Amanda Lillian Opron, PTA
• Orlando Advanced Primary Care LLC
• Orlando Behahavioral Healthcare
• Orlando Family Counseling, Inc.
• Orlando Freedom Medical Clinic, Inc
• Orlando Myofascial Release L.L.C.

• Family Medicine Physician in Maitland, FL
• Providers in Maitland, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.