Center for Individualized Medicine and Age Management, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME55637 Issued in FL

Legal business name

CENTER FOR INDIVIDUALIZED MEDICINE AND AGE MANAGEMENT, INC

Doing business as

CIMA

Practice address

11616 Lake Underhill Rd
Ste 205
Orlando, FL 32825-4463

Phone

(407) 273-7399

Fax

(407) 273-1928

NPI assigned

Nov 2, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Mildred Donis-Rivera, MD

Title

Osner/President

Phone

(407) 273-7399

Specialties & licenses 1

Addresses

Other names 1

• CIMA Doing business as

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1447689203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11616 LAKE UNDERHILL RD",
            "address_2": "STE 205",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254463",
            "telephone_number": "407-273-7399",
            "fax_number": "407-273-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11616 LAKE UNDERHILL RD",
            "address_2": "STE 205",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254463",
            "telephone_number": "407-273-7399",
            "fax_number": "407-273-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INDIVIDUALIZED MEDICINE AND AGE MANAGEMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "DONIS-RIVERA",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_title_or_position": "OSNER/PRESIDENT",
        "authorized_official_telephone_number": "407-273-7399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME55637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CIMA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.