Individual provider Active NPI

Douglas Skylar Orellana

  • Contractor
  • Stuart, FL
National Provider Identifier
1508602525
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
1350 NW Green River Pkwy
Stuart, FL 34994-4086
Phone
(772) 779-6108
NPI assigned
Jul 9, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary
Home Modifications Contractor 171WH0202X

Addresses

Primary practice location

1350 NW Green River Pkwy
Stuart, FL 34994-4086

Mailing address

1350 NW Green River Pkwy
Stuart, FL 34994-4086
Phone (772) 779-6108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1508602525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 NW GREEN RIVER PKWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944086",
            "telephone_number": "772-779-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 NW GREEN RIVER PKWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944086",
            "telephone_number": "772-779-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORELLANA",
        "first_name": "DOUGLAS",
        "middle_name": "SKYLAR",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.