Organization Active NPI

Mini Health Clinic Kissimmee LLC

  • Adult Health Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1194690545
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
MINI HEALTH CLINIC KISSIMMEE LLC
Practice address
318 N John Young Pkwy Ste 5
Kissimmee, FL 34741-4927
Phone
(352) 227-3000
Fax
(352) 505-7738
NPI assigned
Oct 7, 2025
Last updated
Oct 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Authorized official

Name
Mrs. Tresha Elizabeth Williams, APRNNPI 1518402403
Title
Owner/Nurse Practitioner
Phone
(689) 263-3351

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

318 N John Young Pkwy Ste 5
Kissimmee, FL 34741-4927

Mailing address

318 N John Young Pkwy Ste 5
Kissimmee, FL 34741-4927
Phone (352) 227-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251219002134 FL Part B Supplier - Clinic/Group Practice 5294220992 Receives reassigned benefits from 1 practitioner
Practice locations: Kissimmee, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2335964Mini Health Clinic Kissimmee LLC318 North John Young Parkway Suite 5, Kissimmee, FL 34741Certificate of waiverDec 21, 2027

National Provider Directory

National Provider Directory

Locations

318 N John Young Pkwy
Ste 5
Kissimmee, FL 34741
Phone (352) 227-3000

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761523200000",
    "number": "1194690545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 N JOHN YOUNG PKWY STE 5",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414927",
            "telephone_number": "352-227-3000",
            "fax_number": "352-505-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N JOHN YOUNG PKWY STE 5",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414927",
            "telephone_number": "352-227-3000",
            "fax_number": "352-505-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINI HEALTH CLINIC KISSIMMEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TRESHA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "689-263-3351",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.