Organization Active NPI

Christopher J Mavroides MD PA

  • Internal Medicine Physician
  • Okeechobee, FL
National Provider Identifier
1669660908
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CHRISTOPHER J MAVROIDES MD PA
Practice address
1713 Hwy 441 N
Suite a
Okeechobee, FL 34972-1900
Phone
(863) 763-5666
Fax
(863) 763-0121
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Authorized official

Name
Christopher J Mavroides, M.D.
Title
Owner
Phone
(863) 763-5666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1713 Hwy 441 N
Suite a
Okeechobee, FL 34972-1900

Mailing address

1713 Hwy 441 N
Suite a
Okeechobee, FL 34972-1900
Phone (863) 763-5666

Other identifiers 3

IdentifierTypeStateIssuer
061299501MedicaidFL
110164184OtherFLRAIL ROAD MEDICARE
09288OtherFLBCBS

National Provider Directory

National Provider Directory

Locations

1713 US Highway 441 N
Ste A
Okeechobee, FL 34972
Phone (863) 763-5666

Practitioners & affiliated clinicians

Practitioners 2

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": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1669660908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 HWY 441 N",
            "address_2": "SUITE A",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349721900",
            "telephone_number": "863-763-5666",
            "fax_number": "863-763-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 HWY 441 N",
            "address_2": "SUITE A",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349721900",
            "telephone_number": "863-763-5666",
            "fax_number": "863-763-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER J MAVROIDES MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "MAVROIDES",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-763-5666",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061299501",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110164184",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09288",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.