NPIMap

Organization Active NPI

Emc 360, LLC

  • Primary Care Clinic/Center
  • Mount Dora, FL
National Provider Identifier
1790398246
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EMC 360, LLC
Practice address
1008 Juliette Blvd
Mount Dora, FL 32757-6500
Phone
(407) 450-6991
NPI assigned
Aug 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Dr. William Frederick Von Bargen Jr., DO
Title
President
Phone
(407) 450-6991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1008 Juliette Blvd
Mount Dora, FL 32757-6500

Mailing address

1008 Juliette Blvd
Mount Dora, FL 32757-6500
Phone (407) 450-6991

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1790398246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 JULIETTE BLVD",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576500",
            "telephone_number": "407-450-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 JULIETTE BLVD",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576500",
            "telephone_number": "407-450-6991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMC 360, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "VON BARGEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-450-6991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.