NPIMap

Organization Active NPI

Healthnet of Central Florida PA

  • Internal Medicine Physician
  • Titusville, FL
National Provider Identifier
1285796052
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HEALTHNET OF CENTRAL FLORIDA PA
Practice address
1785 Garden St
Titusville, FL 32796-3221
Phone
(321) 264-1000
Fax
(321) 264-4228
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Authorized official

Name
Stephen J Lagergren, M.D.
Title
President
Phone
(321) 264-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1785 Garden St
Titusville, FL 32796-3221

Mailing address

PO Box 3087
1785 Garden Street
Titusville, FL 32781-3087
Phone (321) 264-1000

National Provider Directory

National Provider Directory

Locations

1713 Garden St
Titusville, FL 32796
Phone (321) 269-1621

1309 Garden St
Titusville, FL 32796
Phone (321) 264-1000

Practitioners & affiliated clinicians

Practitioners 5

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1285796052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3087",
            "address_2": "1785 GARDEN STREET",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327813087",
            "telephone_number": "321-264-1000",
            "fax_number": "321-264-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963221",
            "telephone_number": "321-264-1000",
            "fax_number": "321-264-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHNET OF CENTRAL FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "LAGERGREN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-264-1000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.