Congenital Heart Care Center of Florida

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

ME86455 Issued in FL

Legal business name

CONGENITAL HEART CARE CENTER OF FLORIDA

Practice address

425 S Hunt Club Blvd
Ste 1001
Apopka, FL 32703-4947

Phone

(407) 862-1010

Fax

(407) 862-1016

NPI assigned

Mar 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Aurelio Reyes II, MD

Title

President

Phone

(407) 862-1010

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1578094629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N LAKE SYBELIA DR",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514720",
            "telephone_number": "407-862-1010",
            "fax_number": "407-862-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S HUNT CLUB BLVD",
            "address_2": "STE 1001",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327034947",
            "telephone_number": "407-862-1010",
            "fax_number": "407-862-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGENITAL HEART CARE CENTER OF FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "AURELIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-862-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME86455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005948200 091812",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Cardiology Physician in Apopka, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.