W Sand Lake Medical Group LLC

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

W SAND LAKE MEDICAL GROUP LLC

Practice address

2431 Sand Lake Rd
Orlando, FL 32809-7641

Phone

(855) 876-8648

NPI assigned

Dec 22, 2015

Organization subpart

No

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

Authorized official

Name

Nick Matteo

Title

Cfo

Phone

(561) 318-4430

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1558726257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 10TH AVE N STE 302",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334616612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 SAND LAKE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328097641",
            "telephone_number": "855-876-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W SAND LAKE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "MATTEO",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "561-318-4430"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megha Vyas
• Nayana I Vyas, MD
• Neha Vyas, M.D.
• Shayan Vyas, MD
• Vytalflo Rehab Solutions LLC
• W&J Dental LLC
• Melissa Wables
• Kelsy Wachtel
• Cynthia R Waddell, ARNP
• Jennifer M. Waddy, MD

• Addiction Medicine (Internal Medicine) Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Addiction Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.