NPIMap

Organization Active NPI

Florida Physicians Medical Group

  • Non-Pharmacy Dispensing Site
  • Avon Park, FL
National Provider Identifier
1720020282
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
ME27412 Issued in FL
Legal business name
FLORIDA PHYSICIANS MEDICAL GROUP
Practice address
1006 W Pleasant St
Avon Park, FL 33825-2966
Phone
(863) 382-9600
Fax
(904) 399-4421
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jeff Bogan
Title
President
Phone
(904) 962-2123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X ME27412 FL Primary

Addresses

Primary practice location

1006 W Pleasant St
Avon Park, FL 33825-2966

Mailing address

1006 W Pleasant St
Avon Park, FL 33825-2966

Other identifiers 1

IdentifierTypeStateIssuer
1015494OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • DONALD GELDART MD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Donald Geldart MD6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720020282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 W PLEASANT ST",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 W PLEASANT ST",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252966",
            "telephone_number": "863-382-9600",
            "fax_number": "904-399-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PHYSICIANS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOGAN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-962-2123"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME27412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1015494",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DONALD GELDART MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.