Florida East Coast Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FLORIDA EAST COAST MEDICAL GROUP INC

Practice address

1107 N Parrott Ave
Okeechobee, FL 34972

Phone

(863) 763-5122

Fax

(863) 763-1965

NPI assigned

Nov 1, 2007

Last updated

Jul 9, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dmitry Mishelevich III

Title

V-P/Cfo

Phone

(863) 763-6496

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ricardo J. Quintero-Herencia, M.D.

  • Hematology & Oncology Physician
  • Mayaguez, PR
  • NPI 1073511432
  NPD (past)

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1699954057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 N PARROTT AVE",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349722128",
            "telephone_number": "863-763-6496",
            "fax_number": "863-763-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 N PARROTT AVE",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "34972",
            "telephone_number": "863-763-5122",
            "fax_number": "863-763-1965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 N Parrott Ave",
            "address_purpose": "LOCATION",
            "city": "Okeechobee",
            "state": "FL",
            "postal_code": "34972",
            "country_code": "US",
            "telephone_number": "863-763-5122",
            "fax_number": "863-763-1965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLORIDA EAST COAST MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "MISHELEVICH",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "V-P/CFO",
        "authorized_official_telephone_number": "863-763-6496",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Florida Community Health Center, Inc
• Florida Community Health Centers Inc
• Florida Community Health Centers Inc
• Florida Department of Health (Okeechobee County Health Dept)
• Florida Em-I Medical Services, P.a.
• Florida Palms Diagnostics LLC
• Florida Spine Institute of
• Florida Sunshine Diagnostics Inc
• Florida United Radiology LC

• Family Medicine Physician in Okeechobee, FL
• Providers in Okeechobee, 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 Jul 9, 2019; 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.