NPIMap

Organization Active NPI

Orlando Family Physicians, LLC

  • General Practice Physician
  • Orlando, FL
National Provider Identifier
1730757659
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ORLANDO FAMILY PHYSICIANS, LLC
Practice address
5979 Vineland Rd Ste 209
Orlando, FL 32819-7855
Phone
(407) 627-0066
Fax
(407) 440-4054
NPI assigned
Jun 16, 2021
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ORLANDO FAMILY PHYSICIANS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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
(321) 332-6947

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

5979 Vineland Rd Ste 209
Orlando, FL 32819-7855

Mailing address

121 S Orange Ave Ste 940
Orlando, FL 32801-3234
Phone (321) 332-6947

Other identifiers 1

IdentifierTypeStateIssuer
101312513MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Orlando Family Physicians LLC22 organizations share this tax ID, including this one
Part of
Orlando Family Physicians LLC

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1730757659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S ORANGE AVE STE 940",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328013234",
            "telephone_number": "321-332-6947",
            "fax_number": "407-286-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 VINELAND RD STE 209",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197855",
            "telephone_number": "407-627-0066",
            "fax_number": "407-440-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLANDO FAMILY PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORLANDO FAMILY PHYSICIANS, LLC",
        "enumeration_date": "2021-06-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "321-332-6947"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101312513",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.