NPIMap

Organization Active NPI

The Family Physician of BVL

  • Legal Medicine
  • Kissimmee, FL
National Provider Identifier
1336356492
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
ME62672 Issued in FL
Legal business name
THE FAMILY PHYSICIAN OF BVL
Practice address
3071 Michigan Ave
Kissimmee, FL 34744-1501
Phone
(407) 348-9111
Fax
(407) 348-9112
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Authorized official

Name
Dr. Fausto Ronald Burgos, MDNPI 1679503486
Title
Physican
Phone
(407) 348-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X ME62672 FL Primary

Addresses

Primary practice location

3071 Michigan Ave
Kissimmee, FL 34744-1501

Mailing address

3071 Michigan Ave
Kissimmee, FL 34744-1501
Phone (407) 348-9111

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1336356492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 MICHIGAN AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441501",
            "telephone_number": "407-348-9111",
            "fax_number": "407-348-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 MICHIGAN AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441501",
            "telephone_number": "407-348-9111",
            "fax_number": "407-348-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY PHYSICIAN OF BVL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "BURGOS",
        "authorized_official_first_name": "FAUSTO",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "PHYSICAN",
        "authorized_official_telephone_number": "407-348-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "ME62672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.