Organization Active NPI

The Institute of Diabetic Neuropathy

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1205189503
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
THE INSTITUTE OF DIABETIC NEUROPATHY
Practice address
4937 E Colonial Dr
Orlando, FL 32803-4309
Phone
(404) 406-4621
NPI assigned
Oct 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Authorized official

Name
Matthew Buitrago
Title
Administrator
Phone
(954) 559-6062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4937 E Colonial Dr
Orlando, FL 32803-4309

Mailing address

PO Box 570573
Orlando, FL 32857-0573

National Provider Directory

National Provider Directory

Locations

4937 E Colonial Dr
Orlando, FL 32803
Phone (404) 406-4621

NPI Registry JSON

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1205189503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570573",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328570573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4937 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034309",
            "telephone_number": "404-406-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE INSTITUTE OF DIABETIC NEUROPATHY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "BUITRAGO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-559-6062"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 24, 2012; 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.