NPIMap

Organization Active NPI

Florida Hospital Medical Group Inc

  • Mammography Clinic/Center
  • Winter Park, FL
National Provider Identifier
1760715973
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Clinic/CenterTaxonomy code 261QR0206X
License
237620 Issued in FL
Legal business name
FLORIDA HOSPITAL MEDICAL GROUP INC
Practice address
1925 Mizell Ave Ste 105
Winter Park, FL 32792-4155
Phone
(076) 467-4104
Fax
(407) 646-7412
NPI assigned
Sep 8, 2009
Organization subpart
Yes
Parent organization
FLORIDA HOSPITAL MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Mr. Vance Alan McLarren
Title
Coo
Phone
(407) 200-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mammography Clinic/Center 261QR0206X 237620 FL Primary

Addresses

Primary practice location

1925 Mizell Ave Ste 105
Winter Park, FL 32792-4155

Mailing address

1925 Mizell Ave Ste 105
Winter Park, FL 32792-4155
Phone (076) 467-4104

Other identifiers 1

IdentifierTypeStateIssuer
237620OtherFLMAMMOGRAPHY CERT#

Other names 2

  • AdventHealth Medical Group Breast Surgery at Winter Park Doing business as
  • Breast Care Center of Florida Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2314743Adventhealth Medical Group1925 Mizell Ave Suite #306, Winter Park, FL 32792Certificate of waiverNov 25, 2026

National Provider Directory

National Provider Directory
Tax ID family
Florida Hospital Medical Group Inc16 organizations share this tax ID, including this one
Part of
Florida Hospital Medical Group Inc

Other organizations with this tax ID 15

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

View all 15

Locations

1925 Mizell Ave
Ste 105
Winter Park, FL 32792
Phone (407) 646-7410

NPI Registry JSON

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1760715973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE STE 105",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924155",
            "telephone_number": "076-467-4104",
            "fax_number": "407-646-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE STE 105",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924155",
            "telephone_number": "076-467-4104",
            "fax_number": "407-646-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA HOSPITAL MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA HOSPITAL MEDICAL GROUP INC",
        "enumeration_date": "2009-09-08",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "MCLARREN",
        "authorized_official_first_name": "VANCE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "407-200-2700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "FL",
            "license": "237620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMMOGRAPHY CERT#",
            "identifier": "237620",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Medical Group Breast Surgery at Winter Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Breast Care Center of Florida",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.