NPIMap

Organization Active NPI

MP Primary Care Services

  • Nephrology Physician
  • Avon Park, FL
National Provider Identifier
1609512656
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MP PRIMARY CARE SERVICES
Practice address
2778 US Highway 27 S
Avon Park, FL 33825-9755
Phone
(863) 358-0500
Fax
(863) 358-0508
NPI assigned
May 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Orland MataNPI 1235688441
Title
Ceo
Phone
(863) 840-0639

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

2778 US Highway 27 S
Avon Park, FL 33825-9755

Mailing address

2778 US Highway 27 S
Avon Park, FL 33825-9755
Phone (863) 358-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220706000358 FL Part B Supplier - Clinic/Group Practice 7618357880 Receives reassigned benefits from 17 practitioners
Practice locations: Avon Park, FL; Brandon, FL; Kissimmee, FL

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2778 US Highway 27 S
Avon Park, FL 33825
Phone (863) 336-5888

200 N John Young Pkwy
Ste 101
Kissimmee, FL 34741
Phone (407) 518-9339

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1609512656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2778 US HIGHWAY 27 S",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338259755",
            "telephone_number": "863-358-0500",
            "fax_number": "863-358-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2778 US HIGHWAY 27 S",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338259755",
            "telephone_number": "863-358-0500",
            "fax_number": "863-358-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MP PRIMARY CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-11",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "ORLAND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-840-0639"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.