Mid-Florida Primary Care PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MID-FLORIDA PRIMARY CARE PA

Practice address

17809 SE 109TH Ave
Mid-Florida Primary Care PA
Summerfield, FL 34491-8912

Phone

(352) 307-4200

Fax

(352) 307-2520

NPI assigned

Oct 23, 2007

Organization subpart

No

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

Authorized official

Name

Ravi P Gupta, MDNPI 1922077338

Title

President

Phone

(352) 728-4242

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mid Florida Primary Care PA

  • Internal Medicine Physician
  • Leesburg, FL
  • NPI 1598827479

  O20070827000712

  Same enrollment
• Mid-Florida Primary Care PA

  • Internal Medicine Physician
  • Leesburg, FL
  • NPI 1104251370

  O20070827000712

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Mid Florida Primary Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mid-Florida Primary Care

  • Sleep Disorder Diagnostic Clinic/Center
  • Leesburg, FL
  • NPI 1386975910
  NPD tax ID
• Mid-Florida Primary Care PA

  • Internal Medicine Physician
  • Leesburg, FL
  • NPI 1104251370
  NPD tax ID

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ravi P Gupta, M.D.

  • Internal Medicine Physician
  • Leesburg, FL
  • NPI 1922077338
  NPD Authorized official
• Jennifer Aldamuy, APRN

  • Gerontology Nurse Practitioner
  • Leesburg, FL
  • NPI 1508441890
  NPD
• Shannan L Veit, FNP-BC

  • Family Nurse Practitioner
  • Leesburg, FL
  • NPI 1619613437
  NPD
• Lino Ramirez, PA-C

  • Physician Assistant
  • Pharr, TX
  • NPI 1730903790
  NPD

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1235328592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NORTH BLVD W",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485044",
            "telephone_number": "352-728-4242",
            "fax_number": "352-728-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17809 SE 109TH AVE",
            "address_2": "MID-FLORIDA PRIMARY CARE PA",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918912",
            "telephone_number": "352-307-4200",
            "fax_number": "352-307-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-FLORIDA PRIMARY CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-728-4242",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey McKay
• Medical Healing Arts Center,LLC
• Medisupport LLC
• Michael Messina, HIS
• Mid Florida Eye Center PA
• Chandica Misir
• Morningstar Assisted Living, LLC
• Brittney L Morris, OT
• Isaac James Morton, BSA
• Harold Timothy Shane Mounts

• Internal Medicine Physician in Summerfield, FL
• Providers in Summerfield, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.

Verify at the official NPI Registry.