Organization Active NPI

Quality Life Health Center Inc.

  • Health Service Clinic/Center
  • Kissimmee, FL
National Provider Identifier
1497014617
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
ACN305 Issued in FL
Legal business name
QUALITY LIFE HEALTH CENTER INC.
Practice address
804 Emmett St
Suite a
Kissimmee, FL 34741-5434
Phone
(407) 504-5019
Fax
(407) 504-5029
NPI assigned
May 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Authorized official

Name
Dr. Abner Jose Gabaldon, M. D.NPI 1497940043
Title
President
Phone
(407) 452-2498

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
Health Service Clinic/Center 261QH0100X ACN305 FL Primary

Addresses

Primary practice location

804 Emmett St
Suite a
Kissimmee, FL 34741-5434

Mailing address

804 Emmett St
Suite a
Kissimmee, FL 34741-5434
Phone (407) 504-5019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120831000218 FL Part B Supplier - Clinic/Group Practice 6103073879 Receives reassigned benefits from 1 practitioner
Practice locations: Kissimmee, FL

National Provider Directory

National Provider Directory

Locations

804 Emmett St
Ste A
Kissimmee, FL 34741
Phone (407) 223-8603

705 N Main St
Kissimmee, FL 34744
Phone (407) 504-5019

Practitioners & affiliated clinicians

Practitioners 2

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": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346371200000",
    "number": "1497014617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 EMMETT ST",
            "address_2": "SUITE A",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415434",
            "telephone_number": "407-504-5019",
            "fax_number": "407-504-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 EMMETT ST",
            "address_2": "SUITE A",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415434",
            "telephone_number": "407-504-5019",
            "fax_number": "407-504-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY LIFE HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-08-31",
        "status": "A",
        "authorized_official_last_name": "GABALDON",
        "authorized_official_first_name": "ABNER",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-452-2498",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "ACN305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.