Organization Active NPI

Central Florida Ear, Nose and Throat Specialists, PA

  • Specialist
  • Lake Mary, FL
National Provider Identifier
1275830960
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME66400 Issued in FL
Legal business name
CENTRAL FLORIDA EAR, NOSE AND THROAT SPECIALISTS, PA
Practice address
925 Williston Park PT
1001
Lake Mary, FL 32746-2114
Phone
(407) 804-8795
NPI assigned
Feb 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Dr. Michael Branch, M.D.NPI 1649246984
Title
President
Phone
(407) 804-8795

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)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME66400 FL Primary

Addresses

Primary practice location

925 Williston Park PT
1001
Lake Mary, FL 32746-2114

Mailing address

925 Williston Park PT
1001
Lake Mary, FL 32746-2114
Phone (407) 804-8795

Other identifiers 1

IdentifierTypeStateIssuer
251306400MedicaidFL

National Provider Directory

National Provider Directory

Locations

75 Fox Ridge Ct
Ste H
Debary, FL 32713
Phone (386) 668-2663

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1275830960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 WILLISTON PARK PT",
            "address_2": "1001",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462114",
            "telephone_number": "407-804-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 WILLISTON PARK PT",
            "address_2": "1001",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462114",
            "telephone_number": "407-804-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA EAR, NOSE AND THROAT SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "BRANCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-804-8795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME66400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251306400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.