NPIMap

Organization Active NPI

Central Florida Breast Center, PA

  • Surgery Physician
  • Winter Park, FL
National Provider Identifier
1306872767
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS0006978 Issued in FL
Legal business name
CENTRAL FLORIDA BREAST CENTER, PA
Practice address
2200 Glenwood Dr
Suite 201
Winter Park, FL 32792-3315
Phone
(407) 740-5127
Fax
(407) 740-0827
NPI assigned
Jun 25, 2006
Last updated
Apr 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Mr. Aziz Shahbuddin Jasani, M.B.A.
Title
Administrator
Phone
(407) 740-5127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS0006978 FL Primary

Addresses

Primary practice location

2200 Glenwood Dr
Suite 201
Winter Park, FL 32792-3315

Mailing address

2200 Glenwood Dr
Suite 201
Winter Park, FL 32792-3315
Phone (407) 740-5127

Other identifiers 4

IdentifierTypeStateIssuer
1700176OtherFLUNITED HEALTHCARE ID
5339099OtherFLAETNA ID #
57169OtherFLBLUE CROSS BLUE SHIELD ID
9587978OtherFLGHI ID #

National Provider Directory

National Provider Directory

Locations

2200 Glenwood Dr
Ste 201
Winter Park, FL 32792
Phone (407) 740-5127

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1306872767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 GLENWOOD DR",
            "address_2": "SUITE 201",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923315",
            "telephone_number": "407-740-5127",
            "fax_number": "407-740-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 GLENWOOD DR",
            "address_2": "SUITE 201",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923315",
            "telephone_number": "407-740-5127",
            "fax_number": "407-740-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA BREAST CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "JASANI",
        "authorized_official_first_name": "AZIZ",
        "authorized_official_middle_name": "SHAHBUDDIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-740-5127",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS0006978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE ID",
            "identifier": "1700176",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID #",
            "identifier": "5339099",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "57169",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI ID #",
            "identifier": "9587978",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.