Medical Associates of Central Florida Physicians, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MEDICAL ASSOCIATES OF CENTRAL FLORIDA PHYSICIANS, LLC

Practice address

1110 Druid Cir
Lake Wales, FL 33853-4307

Phone

(863) 877-2411

NPI assigned

Aug 18, 2021

Organization subpart

No

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

Authorized official

Name

Dwight Perez

Title

Credentialing Specialist

Phone

(305) 733-5713

Specialties & licenses 1

Addresses

Tax ID family

Medical Associates of Central Florida Physicians LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Medical Associates of Central Florida Physicians, LLC

  • Internal Medicine Physician
  • Haines City, FL
  • NPI 1982370714
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Medical Associates of Central Florida Physicians, LLC

  • Internal Medicine Physician
  • Haines City, FL
  • NPI 1982370714
  NPPES parent name

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1700552080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 DRUID CIR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534307",
            "telephone_number": "863-877-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 DRUID CIR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534307",
            "telephone_number": "863-877-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF CENTRAL FLORIDA PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "305-733-5713"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark John McKeon, D.C.
• Thomas Daniel McKeon Jr., D.C.
• Twascha Rena McKnight
• Marilyn McNeil, LPN
• Medical Associates of Central Florida
• Medical Home Alliance LLC (IMA Medical Group - Lake Wales)
• Medical Imaging Experts of Central Florida, LLC
• Michelle Lora Mendez
• Mental Oasis LLC
• Linda G Metzger, LMT, NCTMB

• Internal Medicine Physician in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.