Individual provider Active NPI

Juan Nabong

  • Non-emergency Medical Transport (VAN)
  • Orlando, FL
National Provider Identifier
1215744891
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
3101-1116740 Issued in FL
Practice address
2605 Wembleycross Way
Orlando, FL 32828-7964
Phone
(407) 810-1585
NPI assigned
Dec 16, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 3101-1116740 FL Primary

Addresses

Primary practice location

2605 Wembleycross Way
Orlando, FL 32828-7964

Mailing address

2605 Wembleycross Way
Orlando, FL 32828-7964
Phone (407) 810-1585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3101-1116740FLMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1215744891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 WEMBLEYCROSS WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287964",
            "telephone_number": "407-810-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 WEMBLEYCROSS WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287964",
            "telephone_number": "407-810-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABONG",
        "first_name": "JUAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "FL",
            "license": "3101-1116740",
            "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 Dec 16, 2024; 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.