Ivps of Kissimmee

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

IVPS OF KISSIMMEE

Practice address

201 Ruby Ave Ste C
Kissimmee, FL 34741-5699

Phone

(772) 546-9591

NPI assigned

Jun 30, 2016

Organization subpart

No

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

Authorized official

Name

Jeneane Wakula

Title

Office Manager

Phone

(772) 546-9591

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1457702425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8929 SE BRIDGE RD",
            "city": "HOBE SOUND",
            "state": "FL",
            "postal_code": "334555312",
            "telephone_number": "772-546-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 RUBY AVE STE C",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415699",
            "telephone_number": "772-546-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVPS OF KISSIMMEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "WAKULA",
        "authorized_official_first_name": "JENEANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "772-546-9591"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bassill Itani, DPT
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• Specialist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.