Organization Active NPI

PBS Corp

  • Specialist
  • Kissimmee, FL
National Provider Identifier
1215427786
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PBS CORP
Practice address
105 E Monument Ave
Kissimmee, FL 34741-5761
Phone
(407) 350-4138
Fax
(321) 250-7463
NPI assigned
May 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Authorized official

Name
Hector L Rodriguez Jr., AB
Title
Director
Phone
(407) 738-0856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X FL Primary

Addresses

Primary practice location

105 E Monument Ave
Kissimmee, FL 34741-5761

Mailing address

PO Box 452848
Kissimmee, FL 34745-2848
Phone (407) 350-4138

Other practice location 1

111 E Monument Ave
Kissimmee, FL 34741-5762
Phone (407) 350-4138

Other identifiers 1

IdentifierTypeStateIssuer
0108457500MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550448000000",
    "number": "1215427786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452848",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347452848",
            "telephone_number": "407-350-4138",
            "fax_number": "321-250-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E MONUMENT AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415761",
            "telephone_number": "407-350-4138",
            "fax_number": "321-250-7463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E Monument Ave",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347415762",
            "country_code": "US",
            "telephone_number": "407-350-4138",
            "fax_number": "321-250-7463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PBS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2019-02-18",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-738-0856",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "AB"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108457500",
            "state": "FL"
        }
    ],
    "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 Feb 18, 2019; 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.