Physician'S Care of Poinciana, LLC

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

License

ME18355 Issued in FL

Legal business name

PHYSICIAN'S CARE OF POINCIANA, LLC

Practice address

3358 W Southport Rd
Kissimmee, FL 34746-2706

Phone

(786) 333-7856

Fax

(305) 846-9389

NPI assigned

May 18, 2011

Organization subpart

No

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

Authorized official

Name

Eliseo D. Espaillat

Title

MGRM

Phone

(786) 333-7856

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1376836726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3358 W SOUTHPORT RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462706",
            "telephone_number": "786-333-7856",
            "fax_number": "305-846-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3358 W SOUTHPORT RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462706",
            "telephone_number": "786-333-7856",
            "fax_number": "305-846-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN'S CARE OF POINCIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "ESPAILLAT",
        "authorized_official_first_name": "ELISEO",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MGRM",
        "authorized_official_telephone_number": "786-333-7856"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "FL",
            "license": "ME18355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ph.D. Medical Genetics in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Ph.D. Medical Genetics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.