Individual provider Active NPI

Kimberly Nguyen Mohar

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1730576695
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS15893 Issued in FL
Practice address
2724 N Hiawassee Rd Ste 100
Orlando, FL 32818-3008
Phone
(407) 906-0082
Fax
(407) 604-2606
NPI assigned
Apr 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS15893 FL Primary

Addresses

Primary practice location

2724 N Hiawassee Rd Ste 100
Orlando, FL 32818-3008

Mailing address

2724 N Hiawassee Rd Ste 100
Orlando, FL 32818-3008
Phone (407) 906-0082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190719001582 FL Practitioner - Internal Medicine 5890087043 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS15893FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Hospitalist Partners PA CurrentSince Jul 1, 2019 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Nov 1, 2021 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Nov 1, 2021 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC PastSince Nov 21, 2021 Accepting new patients

Locations

515 Wekiva Commons Cir
Apopka, FL 32712
Phone (407) 464-9516

1505 53rd Ave E
Bradenton, FL 34203
Phone (941) 357-7950

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

2724 N Hiawassee Rd
Ste 100
Orlando, FL 32818
Phone (407) 906-0082

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

Organizations & group practices 4

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": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1730576695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 N HIAWASSEE RD STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183008",
            "telephone_number": "407-906-0082",
            "fax_number": "407-604-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 N HIAWASSEE RD STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183008",
            "telephone_number": "407-906-0082",
            "fax_number": "407-604-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAR",
        "first_name": "KIMBERLY",
        "middle_name": "NGUYEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.