Community Care Resources of FL LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

COMMUNITY CARE RESOURCES OF FL LLC

Practice address

675 Douglas Ave
Altamonte Springs, FL 32714-2555

Phone

(407) 401-7457

Fax

(407) 598-0885

NPI assigned

Oct 28, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Fancisco Urteaga

Title

President

Phone

(407) 401-7457

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

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

• Lidia Gladney, PMHNP-BC, FNP-C, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
  • NPI 1932681517
  NPD (past)

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582329600000",
    "number": "1366085821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15800 PINES BLVD STE 332",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271212",
            "telephone_number": "954-362-5432",
            "fax_number": "866-240-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 DOUGLAS AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142555",
            "telephone_number": "407-401-7457",
            "fax_number": "407-598-0885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7942 Cypress Gardens Boulevard",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "33884",
            "country_code": "US",
            "telephone_number": "407-401-7457",
            "fax_number": "407-598-0885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY CARE RESOURCES OF FL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-28",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A",
        "authorized_official_last_name": "URTEAGA",
        "authorized_official_first_name": "FANCISCO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-401-7457",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA",
            "identifier": "GRANT",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "athenahealth",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "675 Douglas Ave",
            "city": "Altamonte Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327142555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bartolome E Colom, LMHC
• Colon & Rectal Specialists P a
• Comfort Draw LLC
• Comfortable Care Dental Health Professionals, PA
• Kristen Comito, PA-C
• Community Care Resources, Inc.
• Community Synergy Group, Inc
• Community Synergy Group, Inc
• Community Synergy Group, Inc.
• Community United Outreach, Inc.

• Community Health Worker in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Community Health Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2020; 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.