Organization Active NPI

Central Florida Physical Medicine and Rehabilitation PA

  • Physical Medicine & Rehabilitation Physician
  • Fruitland Park, FL
National Provider Identifier
1366437360
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
CENTRAL FLORIDA PHYSICAL MEDICINE AND REHABILITATION PA
Practice address
3261 US Highway 441/27 Ste B2
Fruitland Park, FL 34731-4492
Phone
(352) 365-9553
Fax
(352) 365-0205
NPI assigned
Sep 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Authorized official

Name
Mrs. Margaret A Maiello
Title
Admin
Phone
(352) 365-9553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X FL Primary

Addresses

Primary practice location

3261 US Highway 441/27 Ste B2
Fruitland Park, FL 34731-4492

Mailing address

PO Box 490216
Leesburg, FL 34749-0216
Phone (352) 365-9553

Other identifiers 3

IdentifierTypeStateIssuer
45486OtherFLBCBSFL GP NUMBER
CH4936OtherFLPALMETTO GOVT (RAILROAD)
259778100MedicaidFL

National Provider Directory

National Provider Directory

Locations

8610A E County Road 466
The Villages, FL 32162
Phone (352) 391-5866

Practitioners & affiliated clinicians

Practitioners 4

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": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1366437360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490216",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347490216",
            "telephone_number": "352-365-9553",
            "fax_number": "352-365-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 US HIGHWAY 441/27 STE B2",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "347314492",
            "telephone_number": "352-365-9553",
            "fax_number": "352-365-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA PHYSICAL MEDICINE AND REHABILITATION PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2018-01-17",
        "status": "A",
        "authorized_official_last_name": "MAIELLO",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "352-365-9553",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL GP NUMBER",
            "identifier": "45486",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GOVT (RAILROAD)",
            "identifier": "CH4936",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259778100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.