Iglesia Bautista Central de Kissimmee, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

IGLESIA BAUTISTA CENTRAL DE KISSIMMEE, INC.

Practice address

2275 Fortune Rd
Kissimmee, FL 34744-4404

Phone

(407) 348-2060

Fax

(407) 348-2063

NPI assigned

Jan 21, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Benjamin Omar Gonzalez

Title

Director

Phone

(407) 348-2060

Specialties & licenses 1

Addresses

Other names 1

• IBCK Family Health Care Center Doing business as

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1689063174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444404",
            "telephone_number": "407-348-2060",
            "fax_number": "407-348-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444404",
            "telephone_number": "407-348-2060",
            "fax_number": "407-348-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGLESIA BAUTISTA CENTRAL DE KISSIMMEE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "OMAR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-348-2060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IBCK Family Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.