NPIMap

Organization Active NPI

Innovacare Central Florida Physicians, LLC

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1780359513
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INNOVACARE CENTRAL FLORIDA PHYSICIANS, LLC
Practice address
6900 Tavistock Lakes Blvd Ste 300
Orlando, FL 32827-7592
Phone
(321) 332-6947
Fax
(407) 286-4515
NPI assigned
Aug 13, 2021
Last updated
Aug 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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
(305) 733-5713

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

6900 Tavistock Lakes Blvd Ste 300
Orlando, FL 32827-7592

Mailing address

6900 Tavistock Lakes Blvd Ste 300
Orlando, FL 32827-7592
Phone (321) 332-6947

National Provider Directory

National Provider Directory
Tax ID family
Innovacare Central Florida Physicians LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628812800000",
    "number": "1780359513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 TAVISTOCK LAKES BLVD STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277592",
            "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": "6900 TAVISTOCK LAKES BLVD STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277592",
            "telephone_number": "321-332-6947",
            "fax_number": "407-286-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVACARE CENTRAL FLORIDA PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "305-733-5713"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 13, 2021; 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.