Organization Active NPI

Urgent Family Clinic, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Kissimmee, FL
National Provider Identifier
1376046839
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
URGENT FAMILY CLINIC, LLC
Practice address
301 N John Young Pkwy
Kissimmee, FL 34741-4901
Phone
(407) 483-7610
Fax
(407) 483-7469
NPI assigned
Mar 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Authorized official

Name
Jose Ovalles
Title
Owner
Phone
(407) 483-7610

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081S0010X Primary
Clinic/Center 261Q00000X
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

301 N John Young Pkwy
Kissimmee, FL 34741-4901

Mailing address

301 N John Young Pkwy
Kissimmee, FL 34741-4901
Phone (407) 483-7610

Other practice location 1

11601 S Orange Blossom Trl Ste 101
Orlando, FL 32837-9437
Phone (407) 271-4605

Other practice location 2

1130 S Semoran Blvd Ste F
Orlando, FL 32807-1457
Phone (407) 440-3605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220728003641 FL Part B Supplier - Clinic/Group Practice 6305228917 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

11601 S Orange Blossom Trl
Ste 101
Orlando, FL 32837
Phone (407) 271-4605

Practitioners & affiliated clinicians

Practitioners 1

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": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1376046839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414901",
            "telephone_number": "407-483-7610",
            "fax_number": "407-483-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414901",
            "telephone_number": "407-483-7610",
            "fax_number": "407-483-7469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11601 S Orange Blossom Trl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328379437",
            "country_code": "US",
            "telephone_number": "407-271-4605",
            "fax_number": "407-271-4740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1130 S Semoran Blvd Ste F",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328071457",
            "country_code": "US",
            "telephone_number": "407-440-3605",
            "fax_number": "407-440-3774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "URGENT FAMILY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "OVALLES",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-483-7610"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.