NPIMap

Organization Active NPI

Lymphedema Clinic of Orlando, Inc

  • General Practice Physician
  • Longwood, FL
National Provider Identifier
1558655647
Registry record updated Nov 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME100524 Issued in FL
Legal business name
LYMPHEDEMA CLINIC OF ORLANDO, INC
Practice address
2139 W State Road 434
Suite #101
Longwood, FL 32779-5019
Phone
(407) 865-6700
NPI assigned
Jun 6, 2011
Last updated
Nov 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2011

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

Authorized official

Name
Dr. Mohammad M Eskandari, M.D.NPI 1184891061
Title
President
Phone
(407) 865-6700

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X ME100524 FL Primary

Addresses

Primary practice location

2139 W State Road 434
Suite #101
Longwood, FL 32779-5019

Mailing address

2139 W State Road 434
Suite #101
Longwood, FL 32779-5019
Phone (407) 865-6700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320451200000",
    "number": "1558655647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 W STATE ROAD 434",
            "address_2": "SUITE #101",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795019",
            "telephone_number": "407-865-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 W STATE ROAD 434",
            "address_2": "SUITE #101",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795019",
            "telephone_number": "407-865-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYMPHEDEMA CLINIC OF ORLANDO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-11-05",
        "status": "A",
        "authorized_official_last_name": "ESKANDARI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-865-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME100524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2011; 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.