NPIMap

Organization Active NPI

MPP Infusion Center of Orlando, LLC

  • Infusion Therapy Clinic/Center
  • Winter Park, FL
National Provider Identifier
1780141739
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
MPP INFUSION CENTER OF ORLANDO, LLC
Practice address
1573 W Fairbanks Ave Ste 200
Winter Park, FL 32789-4679
Phone
(561) 323-8987
NPI assigned
Feb 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Authorized official

Name
Sue Ellen Rottura
Title
Chief Operating Officer
Phone
(561) 323-8987

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

1573 W Fairbanks Ave Ste 200
Winter Park, FL 32789-4679

Mailing address

1726 Cole Blvd Ste 250
Lakewood, CO 80401-3262
Phone (720) 465-5030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190815000157 FL Part B Supplier - Clinic/Group Practice 9931436896 Receives reassigned benefits from 7 practitioners
Practice locations: Winter Park, FL

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
10D2183190MPP Infusion Center of Orlando LLC1573 W Fairbanks Ave Ste 200, Winter Park, FL 32789Certificate of waiverApr 30, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1780141739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 COLE BLVD STE 250",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "804013262",
            "telephone_number": "720-465-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 W FAIRBANKS AVE STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894679",
            "telephone_number": "561-323-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPP INFUSION CENTER OF ORLANDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "ROTTURA",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "561-323-8987"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.