Active NPI
Comprehensive Health Center of Orlando, LLC
- Family Medicine Physician
- Orlando, FL
National Provider Identifier
1205361508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS04440
- Legal business name
- COMPREHENSIVE HEALTH CENTER OF ORLANDO, LLC
- Practice address
- 1011 W Oak Ridge Rd
Orlando, FL 32809-4765 - Phone
- (407) 859-8797
- Fax
- (407) 859-8798
- NPI assigned
- Apr 24, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Mary Ballantine
- Title
- Practice Manager-Certified
- Phone
- (305) 688-4178
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS04440 | FL | Primary |
Addresses
Primary practice location
1011 W Oak Ridge Rd
Orlando, FL 32809-4765
Mailing address
1011 W Oak Ridge Rd
Orlando, FL 32809-4765
Phone (407) 859-8797
Other names 1
- COMPREHENSIVE HEALTH CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2140001 | Comprehensive Health Center of Orlando | Certificate of waiver | Nov 13, 2027 |
National Provider Directory
National Provider DirectoryLocations
655 NW 119th St
North Miami, FL 33168
Phone (305) 403-2219
1011 W Oak Ridge Rd
Orlando, FL 32809
Phone (407) 859-8797
1112 W Oak Ridge Rd
Orlando, FL 32809
Interoperability endpoints
- https://api.platform.athenahealth.com/24158/brand/2/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Orlando, FL
- NPI 1801582028
-
- Family Nurse Practitioner
- North Lauderdale, FL
- NPI 1902342629
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1717372800000",
"number": "1205361508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 W OAK RIDGE RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328094765",
"telephone_number": "407-859-8797",
"fax_number": "407-859-8798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 W OAK RIDGE RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328094765",
"telephone_number": "407-859-8797",
"fax_number": "407-859-8798"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMPREHENSIVE HEALTH CENTER OF ORLANDO, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-04-24",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A",
"authorized_official_last_name": "BALLANTINE",
"authorized_official_first_name": "MARY",
"authorized_official_title_or_position": "PRACTICE MANAGER-CERTIFIED",
"authorized_official_telephone_number": "305-688-4178",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "FL",
"license": "OS04440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "COMPREHENSIVE HEALTH CENTER",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Orlando, FL
- Complete Health and Wellness LLC
- Complete Health Express
- Michael Compolongo, PHARM.D.
- Comprehensive Counseling Care
- Comprehensive Family Medicine of Orlando LLC
- Comprehensive Health X3, LLC
- Comprehensive Neurology Clinic PA
- Comprehensive Outpatient Health & Rehab. Inc
- Comprehensive Psychiatric Services
- Comprehensive Psychiatric Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.