Individual provider Active NPI

Jorge J Daaboul, MD

  • Pediatric Endocrinology Physician
  • Orlando, FL
National Provider Identifier
1720197585
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
ME88751 Issued in FL
Practice address
615 E Princeton Street
Suite 101
Orlando, FL 32803-1435
Phone
(407) 896-2901
Fax
(407) 896-2902
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X ME88751 FL Primary

Addresses

Primary practice location

615 E Princeton Street
Suite 101
Orlando, FL 32803-1435

Mailing address

615 E Princeton Street
Suite 101
Orlando, FL 32803-1435
Phone (407) 896-2901

Other identifiers 1

IdentifierTypeStateIssuer
266072500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714000280 FL Practitioner - EndocrinologyPractitioner - Pediatric Medicine 4385623495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Oct 9, 2013 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Oct 9, 2013 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

615 E Princeton St
Ste 101
Orlando, FL 32803
Phone (407) 236-0006

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1720197585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON STREET",
            "address_2": "SUITE 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031435",
            "telephone_number": "407-896-2901",
            "fax_number": "407-896-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON STREET",
            "address_2": "SUITE 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031435",
            "telephone_number": "407-896-2901",
            "fax_number": "407-896-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAABOUL",
        "first_name": "JORGE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "FL",
            "license": "ME88751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266072500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.