Organization Active NPI

Physician Next Door, LLC

  • Adult Medicine Physician
  • Orlando, FL
National Provider Identifier
1568716645
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
OS7691 Issued in FL
Legal business name
PHYSICIAN NEXT DOOR, LLC
Practice address
1834 N Alafaya TRL
Ste C
Orlando, FL 32826-4743
Phone
(941) 870-0199
Fax
(941) 870-0203
NPI assigned
Oct 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Authorized official

Name
Mr. Gabriel Nuriel
Title
Authorized Official / Shareholder
Phone
(941) 870-0199

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X OS7691 FL Primary

Addresses

Primary practice location

1834 N Alafaya TRL
Ste C
Orlando, FL 32826-4743

Mailing address

1834 N Alafaya TRL
Ste C
Orlando, FL 32826-4743
Phone (941) 870-0199

Other identifiers 1

IdentifierTypeStateIssuer
HM571AOtherFLMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

1834 N Alafaya Trl
Ste C
Orlando, FL 32826
Phone (941) 870-0199

3135 Southgate Cir
Sarasota, FL 34239
Phone (941) 870-0194

Practitioners & affiliated clinicians

Practitioners 1

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": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1568716645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1834 N ALAFAYA TRL",
            "address_2": "STE C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264743",
            "telephone_number": "941-870-0199",
            "fax_number": "941-870-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 N ALAFAYA TRL",
            "address_2": "STE C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264743",
            "telephone_number": "941-870-0199",
            "fax_number": "941-870-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN NEXT DOOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "NURIEL",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL / SHAREHOLDER",
        "authorized_official_telephone_number": "941-870-0199",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "OS7691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "HM571A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.