Organization Active NPI

Williamson, Ferrara, Gallagher, Dejesus MD. PA

  • Clinical Medical Laboratory
  • Orlando, FL
National Provider Identifier
1376845123
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
800025894 Issued in FL
Legal business name
WILLIAMSON, FERRARA, GALLAGHER, DEJESUS MD. PA
Practice address
308 Groveland St
Orlando, FL 32804-4019
Phone
(407) 648-9151
Fax
(407) 426-7269
NPI assigned
Nov 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Authorized official

Name
Mr. Douglas W Oakley
Title
Business Manager
Phone
(407) 648-9151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 800025894 FL Primary

Addresses

Primary practice location

308 Groveland St
Orlando, FL 32804-4019

Mailing address

110 W Underwood St
Suite a
Orlando, FL 32806-1139
Phone (407) 648-9151

Other names 1

  • Colon and Rectal Pathology Lab Doing business as

National Provider Directory

National Provider Directory

Locations

850001 P Box
Orlando, FL 32885

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1376845123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W UNDERWOOD ST",
            "address_2": "SUITE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061139",
            "telephone_number": "407-648-9151",
            "fax_number": "407-426-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 GROVELAND ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044019",
            "telephone_number": "407-648-9151",
            "fax_number": "407-426-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSON, FERRARA, GALLAGHER, DEJESUS MD. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "OAKLEY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "407-648-9151",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800025894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colon and Rectal Pathology Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.