NPIMap

Organization Active NPI

Florida Hospital Medical Group Inc

Doing business as Orlando Neurosurgery

  • Neurological Surgery Physician
  • Winter Park, FL
National Provider Identifier
1629060033
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
FLORIDA HOSPITAL MEDICAL GROUP INC
Doing business as
Orlando Neurosurgery
Practice address
1605 W Fairbanks Ave
Winter Park, FL 32789-4603
Phone
(407) 975-0200
Fax
(470) 975-0209
NPI assigned
Aug 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Authorized official

Name
Mr. Bryan Stiltz
Title
President
Phone
(407) 200-2733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

1605 W Fairbanks Ave
Winter Park, FL 32789-4603

Mailing address

1605 W Fairbanks Ave
Winter Park, FL 32789-4603
Phone (407) 975-0200

Other identifiers 2

IdentifierTypeStateIssuer
34958OtherFLBLUE CROSS/BLUE SHIELD
268791700MedicaidFL

Other names 1

  • Orlando Neurosurgery Doing business as

National Provider Directory

National Provider Directory

Locations

1801 Cook Ave
Orlando, FL 32806
Phone (407) 425-7470

1225 Waterman Way
Ste 1225
Tavares, FL 32778

1605 W Fairbanks Ave
Winter Park, FL 32789
Phone (407) 845-8356

Practitioners & affiliated clinicians

Practitioners 12

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": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1629060033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 W FAIRBANKS AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894603",
            "telephone_number": "407-975-0200",
            "fax_number": "470-975-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 W FAIRBANKS AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894603",
            "telephone_number": "407-975-0200",
            "fax_number": "470-975-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA HOSPITAL MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "STILTZ",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-200-2733",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "34958",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268791700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orlando Neurosurgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.