Organization Active NPI

Medfund LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Kissimmee, FL
National Provider Identifier
1730182825
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
License
HCC5196 Issued in FL
Legal business name
MEDFUND LLC
Doing business as
Horizon Kissimmee LLC
Practice address
810 N John Young Pkwy
Kissimmee, FL 34741-4912
Phone
(239) 573-6333
Fax
(407) 847-8749
NPI assigned
May 23, 2005
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
Mr. Martin J Kern
Title
Senior Vice President
Phone
(941) 925-3490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X HCC5196 FL Primary

Addresses

Primary practice location

810 N John Young Pkwy
Kissimmee, FL 34741-4912

Mailing address

240 N Washington Blvd
Sarasota, FL 34236-5945
Phone (941) 925-3490

Other identifiers 2

IdentifierTypeStateIssuer
105715-02OtherFLCITRUS HMO
V2614OtherFLBCBS PROVIDER #

Other names 1

  • Horizon Kissimmee LLC Doing business as

National Provider Directory

National Provider Directory

Locations

810 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 501-7960

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730182825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N WASHINGTON BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342365945",
            "telephone_number": "941-925-3490",
            "fax_number": "941-953-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414912",
            "telephone_number": "239-573-6333",
            "fax_number": "407-847-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFUND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "941-925-3490",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "FL",
            "license": "HCC5196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITRUS HMO",
            "identifier": "105715-02",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "V2614",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizon Kissimmee LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kissimmee, 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.