Active NPI
Hitchcock Health Institute PA
- Family Medicine Physician
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME79029
- Legal business name
- HITCHCOCK HEALTH INSTITUTE PA
- Practice address
- 7932 W Sand Lake Rd
Suite 201
Orlando, FL 32819-7263 - Phone
- (407) 578-3303
- Fax
- (407) 578-9144
- NPI assigned
- Jul 5, 2006
- 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
- Lara Davis Hitchcock, M.D.
- Title
- Owner/Doctor
- Phone
- (407) 578-3303
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME79029 | FL | Primary |
Addresses
Primary practice location
7932 W Sand Lake Rd
Suite 201
Orlando, FL 32819-7263
Mailing address
7932 W Sand Lake Rd
Suite 201
Orlando, FL 32819-7263
Phone (407) 578-3303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME79029 | Other | FL | STATE LICENSE NUMBER |
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 |
|---|---|---|---|
| 10D1047395 | Hitchcock Health Institute | Certificate of waiver | Nov 2, 2027 |
National Provider Directory
National Provider DirectoryLocations
7932 W Sand Lake Rd
Ste 201
Orlando, FL 32819
Phone (407) 447-9038
1803 Park Center Dr
Ste 115
Orlando, FL 32835
Phone (407) 578-3303
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.
-
- Family Medicine Physician
- Orlando, FL
- NPI 1962457465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1524787200000",
"number": "1225069917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7932 W SAND LAKE RD",
"address_2": "SUITE 201",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328197263",
"telephone_number": "407-578-3303",
"fax_number": "407-578-9144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7932 W SAND LAKE RD",
"address_2": "SUITE 201",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328197263",
"telephone_number": "407-578-3303",
"fax_number": "407-578-9144"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HITCHCOCK HEALTH INSTITUTE PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-05",
"last_updated": "2018-04-27",
"status": "A",
"authorized_official_last_name": "HITCHCOCK",
"authorized_official_first_name": "LARA",
"authorized_official_middle_name": "DAVIS",
"authorized_official_title_or_position": "OWNER/DOCTOR",
"authorized_official_telephone_number": "407-578-3303",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "FL",
"license": "ME79029",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "ME79029",
"state": "FL"
}
],
"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 Apr 27, 2018; 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.