NPIMap

Organization Active NPI

Dedicated Senior Medical Center of Florida, LLC

  • Non-Pharmacy Dispensing Site
  • Orlando, FL
National Provider Identifier
1811599376
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED SENIOR MEDICAL CENTER OF FLORIDA, LLC
Practice address
4613 S Orange Blossom TRL
Orlando, FL 32839-1705
Phone
(407) 232-9833
NPI assigned
Nov 10, 2020
Organization subpart
Yes
Parent organization
DEDICATED SENIOR MEDICAL CENTER OF FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

Name
Mary Chen
Title
Owner
Phone
(305) 628-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

4613 S Orange Blossom TRL
Orlando, FL 32839-1705

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710

Other names 1

  • Dedicated Senior Medical Center Orange Blossom Trail Doing business as

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
10D2227861Dedicated Senior Medical Center - Orange Blossom4613 S Orange Blossom Trail, Orlando, FL 32839Certificate of waiverJun 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Senior Medical Center of Florida LLC28 organizations share this tax ID, including this one
Part of
Dedicated Senior Medical Center of Florida LLC

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1811599376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 S ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328391705",
            "telephone_number": "407-232-9833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED SENIOR MEDICAL CENTER OF FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED SENIOR MEDICAL CENTER OF FLORIDA, LLC",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center Orange Blossom Trail",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.