NPIMap

Organization Active NPI

Central Florida Dreamplex LLC

  • Developmental Therapist
  • Clermont, FL
National Provider Identifier
1457526378
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Legal business name
CENTRAL FLORIDA DREAMPLEX LLC
Practice address
2400 S Highway 27 Ste B201
Clermont, FL 34711-6816
Phone
(352) 394-0212
Fax
(352) 241-6361
NPI assigned
Apr 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Authorized official

Name
Amy Jo GomesNPI 1144317595
Title
President
Phone
(352) 406-0922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 222Q00000X Primary

Addresses

Primary practice location

2400 S Highway 27 Ste B201
Clermont, FL 34711-6816

Mailing address

PO Box 120547
Clermont, FL 34712-0547
Phone (352) 394-0212

Other identifiers 1

IdentifierTypeStateIssuer
811908200MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Central Florida Dreamplex LLC3 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.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1457526378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120547",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347120547",
            "telephone_number": "352-394-0212",
            "fax_number": "352-241-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S HIGHWAY 27 STE B201",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116816",
            "telephone_number": "352-394-0212",
            "fax_number": "352-241-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA DREAMPLEX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-406-0922"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "811908200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.