NPIMap

Organization Active NPI

BVL Family Medical Center

Doing business as Poinciana Family Medical Center

  • Non-Pharmacy Dispensing Site
  • Kissimmee, FL
National Provider Identifier
1679991988
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
ME36805 Issued in FL
Legal business name
BVL FAMILY MEDICAL CENTER
Doing business as
Poinciana Family Medical Center
Practice address
4551 Pleasant Hill Rd
Kissimmee, FL 34759-3422
Phone
(407) 847-2212
NPI assigned
Apr 3, 2014
Organization subpart
Yes
Parent organization
MEDVANTX, INC,As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X ME36805 FL Primary

Addresses

Primary practice location

4551 Pleasant Hill Rd
Kissimmee, FL 34759-3422

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • Poinciana Family Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
BVL Family Medical Center3 organizations share this tax ID, including this one
Part of
Tri - State Medical Group Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1679991988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4551 PLEASANT HILL RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593422",
            "telephone_number": "407-847-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BVL FAMILY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC,",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME36805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poinciana Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 3, 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.