Organization Active NPI

Heart of Florida OB/GYN Associates PA

  • Specialist
  • Davenport, FL
National Provider Identifier
1790871028
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HEART OF FLORIDA OB/GYN ASSOCIATES PA
Practice address
2221 North Blvd W
Davenport, FL 33837-8990
Phone
(863) 421-7600
Fax
(863) 421-7551
NPI assigned
Oct 5, 2006
Last updated
Nov 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Authorized official

Name
Marci Kay Harris
Title
Offc MGR
Phone
(863) 421-7600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

2221 North Blvd W
Davenport, FL 33837-8990

Mailing address

PO Box 667
Davenport, FL 33836-0667
Phone (863) 421-7600

Other identifiers 1

IdentifierTypeStateIssuer
258034900MedicaidFL

National Provider Directory

National Provider Directory

Locations

2221 North Blvd W
Davenport, FL 33837
Phone (863) 421-7600

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384387200000",
    "number": "1790871028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 667",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338360667",
            "telephone_number": "863-421-7600",
            "fax_number": "863-421-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 NORTH BLVD W",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378990",
            "telephone_number": "863-421-7600",
            "fax_number": "863-421-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF FLORIDA OB/GYN ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2013-11-14",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MARCI",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OFFC MGR",
        "authorized_official_telephone_number": "863-421-7600"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258034900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; 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.