NPIMap

Organization Active NPI

Florida Infectious Disease Specialists Inc.

  • Infectious Disease Physician
  • Kissimmee, FL
National Provider Identifier
1801143136
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
FLORIDA INFECTIOUS DISEASE SPECIALISTS INC.
Practice address
102 Park Place Blvd BLDG D
Kissimmee, FL 34741-2358
Phone
(407) 944-4900
Fax
(407) 483-0688
NPI assigned
Aug 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Shoaib Siddiqui, M.DNPI 1609079649
Title
President
Phone
(321) 229-3505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

102 Park Place Blvd BLDG D
Kissimmee, FL 34741-2358

Mailing address

10407 Emerald Woods Ave
Orlando, FL 32836-5971
Phone (321) 229-3505

Other practice location 1

10407 Emerald Woods Ave
Orlando, FL 32836-5971
Phone (321) 229-3505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130215000310 FL Part B Supplier - Clinic/Group Practice 8628222841 Receives reassigned benefits from 23 practitioners
Practice locations: Kissimmee, FL

National Provider Directory

National Provider Directory

Locations

102 Park Place Blvd
Ste D2
Kissimmee, FL 34741
Phone (407) 944-4900

102 Park Place Blvd
Bldg D
Kissimmee, FL 34741
Phone (321) 229-3505

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801143136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10407 EMERALD WOODS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365971",
            "telephone_number": "321-229-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PARK PLACE BLVD BLDG D",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412358",
            "telephone_number": "407-944-4900",
            "fax_number": "407-483-0688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10407 Emerald Woods Ave",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328365971",
            "country_code": "US",
            "telephone_number": "321-229-3505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLORIDA INFECTIOUS DISEASE SPECIALISTS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "SHOAIB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-229-3505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.