Organization Active NPI

Laurel Oaks Family Practice of Central Florida PA

  • Family Medicine Physician
  • Ocoee, FL
National Provider Identifier
1346567484
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS7986 Issued in FL
Legal business name
LAUREL OAKS FAMILY PRACTICE OF CENTRAL FLORIDA PA
Practice address
2711 Maguire Rd
Ocoee, FL 34761-4797
Phone
(407) 877-1990
Fax
(407) 877-1995
NPI assigned
Apr 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Authorized official

Name
Dr. James Bradley Wilson Jr., D.O.
Title
President
Phone
(407) 877-1990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS7986 FL Primary

Addresses

Primary practice location

2711 Maguire Rd
Ocoee, FL 34761-4797

Mailing address

2711 Maguire Rd
Ocoee, FL 34761-4797
Phone (407) 877-1990

National Provider Directory

National Provider Directory

Locations

2711 Maguire Rd
Ocoee, FL 34761
Phone (407) 268-0000

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1346567484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 MAGUIRE RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614797",
            "telephone_number": "407-877-1990",
            "fax_number": "407-877-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 MAGUIRE RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614797",
            "telephone_number": "407-877-1990",
            "fax_number": "407-877-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL OAKS FAMILY PRACTICE OF CENTRAL FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-877-1990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; 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.