Organization Active NPI

Vip Family Practice LLC

  • Family Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1669725552
Registry record updated Feb 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ACN235 Issued in FL
Legal business name
VIP FAMILY PRACTICE LLC
Practice address
401 W Oak St
Kissimmee, FL 34741-4931
Phone
(407) 730-9911
Fax
(407) 730-3545
NPI assigned
Oct 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2023

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

Authorized official

Name
Frank John Yanez, MDNPI 1578780524
Title
Medical Director/Owner
Phone
(407) 674-2044

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ACN235 FL Primary

Addresses

Primary practice location

401 W Oak St
Kissimmee, FL 34741-4931

Mailing address

401 W Oak St
Kissimmee, FL 34741-4931
Phone (407) 674-2044

Other practice location 1

1192 Cypress Glen Cir
Kissimmee, FL 34741-7560
Phone (407) 674-2044

Other practice location 2

405 W Oak St
Kissimmee, FL 34741-4931
Phone (407) 674-2044

Other practice location 3

483 N Semoran Blvd Ste 210
Winter Park, FL 32792-3800
Phone (407) 674-2044

Other identifiers 1

IdentifierTypeStateIssuer
000864700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140924000692 FL Part B Supplier - Clinic/Group Practice 7113146168 Receives reassigned benefits from 12 practitioners
Practice locations: Kissimmee, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2051061Vip Family Practice401 W Oak St, Kissimmee, FL 34741Certificate of waiverDec 11, 2026
10D2255698Vip Family Practice1192 Cypress Glenn Cir, Kissimmee, FL 34741Certificate of waiverMar 15, 2028
10D2264613Vip Family Practice483 N Semoran Blvd, Suite 210, Winter Park, FL 32792Certificate of waiverJul 17, 2026
10D2264619Vip Family Practice405 W Oak St, Kissimmee, FL 34741Certificate of waiverJul 17, 2028

National Provider Directory

National Provider Directory

Locations

401 W Oak St
Kissimmee, FL 34741
Phone (407) 674-2044

405 W Oak St
Kissimmee, FL 34741
Phone (407) 674-2044

401 W Oak St
#403
Kissimmee, FL 34741

483 N Semoran Blvd
Ste 210
Winter Park, FL 32792
Phone (407) 674-2044

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEBFCA

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676073600000",
    "number": "1669725552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414931",
            "telephone_number": "407-674-2044",
            "fax_number": "407-674-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414931",
            "telephone_number": "407-730-9911",
            "fax_number": "407-730-3545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1192 Cypress Glen Cir",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347417560",
            "country_code": "US",
            "telephone_number": "407-674-2044",
            "fax_number": "407-674-2049",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347414931",
            "country_code": "US",
            "telephone_number": "407-674-2044",
            "fax_number": "407-674-2049",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "483 N Semoran Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327923800",
            "country_code": "US",
            "telephone_number": "407-674-2044",
            "fax_number": "407-674-2049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIP FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2023-02-11",
        "certification_date": "2023-02-11",
        "status": "A",
        "authorized_official_last_name": "YANEZ",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "407-674-2044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ACN235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000864700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.