NPIMap

Organization Active NPI

Medstation Orlando Primary Care LLC

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1316496003
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0049457 Issued in FL
Legal business name
MEDSTATION ORLANDO PRIMARY CARE LLC
Practice address
1601 Park Center Dr
Suite # 9
Orlando, FL 32835-5700
Phone
(321) 219-9301
Fax
(954) 582-6715
NPI assigned
Sep 23, 2016
Last updated
Sep 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Authorized official

Name
Jaime Colombino Gonzalez, MDNPI 1316936461
Title
Ambr
Phone
(352) 394-5535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0049457 FL Primary

Addresses

Primary practice location

1601 Park Center Dr
Suite # 9
Orlando, FL 32835-5700

Mailing address

1601 Park Center Dr
Suite # 9
Orlando, FL 32835-5700
Phone (321) 219-9301

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1316496003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 PARK CENTER DR",
            "address_2": "SUITE # 9",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355700",
            "telephone_number": "321-219-9301",
            "fax_number": "954-582-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 PARK CENTER DR",
            "address_2": "SUITE # 9",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328355700",
            "telephone_number": "321-219-9301",
            "fax_number": "954-582-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTATION ORLANDO PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "COLOMBINO",
        "authorized_official_title_or_position": "AMBR",
        "authorized_official_telephone_number": "352-394-5535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0049457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.