Active NPI
Physician Management Services of Florida LLC
- Family Medicine Physician
- Orlando, FL
National Provider Identifier
1679883151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- PHYSICIAN MANAGEMENT SERVICES OF FLORIDA LLC
- Practice address
- 400 Gatlin Ave
Orlando, FL 32806-6940 - Phone
- (888) 829-8550
- Fax
- (888) 843-7191
- NPI assigned
- Oct 18, 2010
- Organization subpart
- Yes
- Parent organization
- VAXCARE CORPORATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Casey Deloach
- Title
- President
- Phone
- (888) 829-8550
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
400 Gatlin Ave
Orlando, FL 32806-6940
Mailing address
400 Gatlin Ave
Orlando, FL 32806-6940
Phone (888) 829-8550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHC059 | Other | MEDICARE PTAN |
Other names 1
- VaxCare Florida LLC
National Provider Directory
National Provider Directory- Part of
- Vaxcare Corporation
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Family Medicine Physician
- Orlando, FL
- NPI 1316058217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287360000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1379635200000",
"number": "1679883151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 GATLIN AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328066940",
"telephone_number": "888-829-8550",
"fax_number": "888-843-7191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 GATLIN AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328066940",
"telephone_number": "888-829-8550",
"fax_number": "888-843-7191"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHYSICIAN MANAGEMENT SERVICES OF FLORIDA LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VAXCARE CORPORATION",
"enumeration_date": "2010-10-18",
"last_updated": "2013-09-20",
"status": "A",
"authorized_official_last_name": "DELOACH",
"authorized_official_first_name": "CASEY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "888-829-8550"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "PHC059",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "VaxCare Florida LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.