NPIMap

Organization Active NPI

Bridge of Hope Central Florida

  • Speech-Language Pathologist
  • Kissimmee, FL
National Provider Identifier
1245678184
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA10475 Issued in FL
Legal business name
BRIDGE OF HOPE CENTRAL FLORIDA
Practice address
1331 Kevstin Dr
Kissimmee, FL 34744-5844
Phone
(407) 575-4536
Fax
(321) 250-7425
NPI assigned
Jun 13, 2013
Last updated
Jun 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Authorized official

Name
Hector L Rodriguez, AS
Title
Operation Manager
Phone
(407) 575-4636

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT 21145 FL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT 1181 FL
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SA10475 FL Primary

Addresses

Primary practice location

1331 Kevstin Dr
Kissimmee, FL 34744-5844

Mailing address

PO Box 452878
Kissimmee, FL 34745-2878
Phone (407) 575-4636

Other identifiers 3

IdentifierTypeStateIssuer
000867500MedicaidFL
000867502MedicaidFL
000867501MedicaidFL

Other names 1

  • Bridge of Hope Central Florida Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Bridge of Hope Central Florida Corp8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1331 Kevstin Dr
Kissimmee, FL 34744

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1245678184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452878",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347452878",
            "telephone_number": "407-575-4636",
            "fax_number": "321-250-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 KEVSTIN DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347445844",
            "telephone_number": "407-575-4536",
            "fax_number": "321-250-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE OF HOPE CENTRAL FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPERATION MANAGER",
        "authorized_official_telephone_number": "407-575-4636",
        "authorized_official_credential": "AS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 21145",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 1181",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA10475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000867500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000867502",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000867501",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridge of Hope Central Florida",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jun 13, 2013; 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.