Kissimmee Primary Care Anti-Aging Wellness and Weight Loss Center PA

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

KISSIMMEE PRIMARY CARE ANTI-AGING WELLNESS AND WEIGHT LOSS CENTER PA

Practice address

1520 N John Young Pkwy
Kissimmee, FL 34741-3219

Phone

(407) 518-7700

Fax

(407) 518-7100

NPI assigned

Nov 6, 2007

Organization subpart

No

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

Authorized official

Name

Mohamed H Gajraj, MD

Title

President

Phone

(407) 518-7700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Kissimmee Primary Care Anti-Aging Wellness and Weightloss Center PA

  • Internal Medicine Physician
  • Kissimmee, FL
  • NPI 1952617276

  O20090211000748

  Same enrollment

Tax ID family

Kissimmee Primary Care Anti Aging Wellness and Weightloss Center PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Kissimmee Primary Care Anti-Aging Wellness and Weightloss Center PA

  • Internal Medicine Physician
  • Kissimmee, FL
  • NPI 1952617276
  NPD tax ID
• Kissimmee Primary Care/ Anti-Aging Wellness and Weight Loss Center PA

  • General Practice Physician
  • Kissimmee, FL
  • NPI 1528212651
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Saeed Ahmad, M.D.

  • Family Medicine Physician
  • Kissimmee, FL
  • NPI 1336150432
  NPD
• Syed Amir Ahmed, MD

  • Infectious Disease Physician
  • Kissimmee, FL
  • NPI 1396794186
  NPD (past)

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234742400000",
    "number": "1396925574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413219",
            "telephone_number": "407-518-7700",
            "fax_number": "407-518-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413219",
            "telephone_number": "407-518-7700",
            "fax_number": "407-518-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISSIMMEE PRIMARY CARE ANTI-AGING WELLNESS AND WEIGHT LOSS CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2009-02-16",
        "status": "A",
        "authorized_official_last_name": "GAJRAJ",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-518-7700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kissimmee Nephrology & Hypertension, PA
• Kissimmee Nursing and Rehabilitation Center by Harborview LLC
• Kissimmee Opco LLC
• Kissimmee Opco, LLC
• Kissimmee Physician'S Clinic
• Kissimmee Primary Care Anti-Aging Wellness and Weightloss Center PA
• Kissimmee Primary Care/ Anti-Aging Wellness and Weight Loss Center PA
• Kissimmee SNF LLC
• Kissimmee Spine and Rehabilitation Center, LLC
• Kissimmee Surgicare LTD

• Adult Medicine Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; 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.