Maitland Avenue Urgent Care PA

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

OS5330 Issued in FL

Legal business name

MAITLAND AVENUE URGENT CARE PA

Practice address

411 Maitland Ave Ste 1002
Altamonte Springs, FL 32701-5448

Phone

(321) 207-0002

Fax

(321) 207-2003

NPI assigned

Jan 31, 2008

Organization subpart

No

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

Authorized official

Name

Seth T Johnson, D.O.NPI 1497726608

Title

President

Phone

(321) 207-0002

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PA Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Seth T Johnson, DO

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1497726608
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1285812362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MAITLAND AVE",
            "address_2": "SUITE 1002",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015448",
            "telephone_number": "321-207-0002",
            "fax_number": "321-207-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MAITLAND AVE STE 1002",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015448",
            "telephone_number": "321-207-0002",
            "fax_number": "321-207-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAITLAND AVENUE URGENT CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SETH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-207-0002",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "OS5330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051599000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicole Lisett Magrann, PA-C
• Manimala Mahesh
• Rochelle Maheshwary-Alicea
• Shoval Maidenberg, RBT
• Nicole Mailhot
• Anibal Jose Maldonado, M.D.
• Carmen Maldonado
• Gabriel Maldonado
• Bernadette Mallari
• Alexis Maloney, MS, OTR/L

• Urgent Care Clinic/Center in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Urgent Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.