The Family Doctors of Buena Ventura PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME62124 Issued in FL

Legal business name

THE FAMILY DOCTORS OF BUENA VENTURA PA

Practice address

14050 Town Loop Blvd
Suite 201
Orlando, FL 32837-6190

Phone

(407) 348-0399

Fax

(407) 348-8350

NPI assigned

May 4, 2007

Last updated

Aug 20, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marin Bautista, M.DNPI 1528092400

Title

President

Phone

(407) 348-0399

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Marin Bautista, M.D.

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1528092400
  Authorized official Same address or phone
• Fausto Ronald Burgos, M.D.

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1679503486
  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1316159023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 TOWN LOOP BLVD",
            "address_2": "SUITE 201",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376190",
            "telephone_number": "407-348-0399",
            "fax_number": "407-348-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 TOWN LOOP BLVD",
            "address_2": "SUITE 201",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376190",
            "telephone_number": "407-348-0399",
            "fax_number": "407-348-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY DOCTORS OF BUENA VENTURA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "MARIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-348-0399",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME62124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370827600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.