Florida Medical

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

OS4187 Issued in FL

Legal business name

FLORIDA MEDICAL

Doing business as

Revolution Medical

Practice address

711 N Orlando Ave
Suite 203
Maitland, FL 32751-4403

Phone

(407) 636-5391

NPI assigned

Apr 8, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Robert Carder

Title

President

Phone

(407) 636-5391

Specialties & licenses 1

Addresses

Other names 1

• Revolution Medical Doing business as

Locations

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

{
    "created_epoch": "1491609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491609600000",
    "number": "1396278131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N ORLANDO AVE",
            "address_2": "SUITE 203",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514403",
            "telephone_number": "407-636-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N ORLANDO AVE",
            "address_2": "SUITE 203",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514403",
            "telephone_number": "407-636-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-08",
        "last_updated": "2017-04-08",
        "status": "A",
        "authorized_official_last_name": "CARDER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-636-5391",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "OS4187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revolution Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Hartman Fleming, OTR
• Brandi Olivia Fliegelman, MSW
• Florida Home Companion
• Florida Hospital Healthcare System, Inc
• Florida Hospital Healthcare System, Inc
• Florida Pediatric Associates, LLC
• Florida Psychiatric Associates LLC
• Florida Vascular Consultants PA
• Florida Woman Care, LLC
• Florida Wound & Healing PA

• Non-Pharmacy Dispensing Site in Maitland, FL
• Providers in Maitland, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2017; 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.