NPIMap

Organization Active NPI

FP Medical

  • General Practice Physician
  • Fort Pierce, FL
National Provider Identifier
1316233588
Registry record updated Jun 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FP MEDICAL
Practice address
1905 S 25TH St
Suite 100
Fort Pierce, FL 34947-4739
Phone
(772) 467-9083
Fax
(772) 464-6478
NPI assigned
Jun 25, 2011
Last updated
Jun 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2011

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

Authorized official

Name
Mr. Peter Blake
Title
Owner
Phone
(772) 467-9083

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1905 S 25TH St
Suite 100
Fort Pierce, FL 34947-4739

Mailing address

1905 S 25TH St
Suite 100
Fort Pierce, FL 34947-4739
Phone (772) 467-9083

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1308960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308960000000",
    "number": "1316233588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 S 25TH ST",
            "address_2": "SUITE 100",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474739",
            "telephone_number": "772-467-9083",
            "fax_number": "772-464-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 S 25TH ST",
            "address_2": "SUITE 100",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474739",
            "telephone_number": "772-467-9083",
            "fax_number": "772-464-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FP MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-25",
        "last_updated": "2011-06-25",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-467-9083",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2011; 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.