Davita Medical Group Florida Cin

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DAVITA MEDICAL GROUP FLORIDA CIN

Practice address

2304 Aloma Ave
Winter Park, FL 32792-3330

Phone

(407) 679-9222

NPI assigned

Sep 20, 2017

Organization subpart

No

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

Authorized official

Name

Lauren Edgington

Title

Cfo

Phone

(727) 824-0780

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1669981858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH ST N STE 200",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923330",
            "telephone_number": "407-679-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA MEDICAL GROUP FLORIDA CIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "EDGINGTON",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "727-824-0780"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marnie Davis, MA, LMHC, CEDS
• Natalya Olivia Davis, DPT
• Ronald G Davis, MD
• Sheila Anita Davis, ED.D, LMHC, NCC
• Steven M Davis, M.D.
• Alajha Nichole Dawson
• Deborah Day, PSY.D
• Dayone Dental PLLC
• De Healthcare Consulting, LLC
• Omar E De Jesus

• Family Medicine Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.