Individual provider Active NPI

Philip J Ciufo Jr., PA-C

  • Medical Physician Assistant
  • Apopka, FL
National Provider Identifier
1821074626
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA1966 Issued in FL
Practice address
1049 W Orange Blossom TRL
Apopka, FL 32712-3482
Phone
(407) 884-2952
Fax
(407) 884-9352
NPI assigned
Dec 22, 2005
Last updated
Aug 14, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1966 FL Primary

Addresses

Primary practice location

1049 W Orange Blossom TRL
Apopka, FL 32712-3482

Mailing address

PO Box 616788
Orlando, FL 32861-6788
Phone (407) 447-7105

Other identifiers 1

IdentifierTypeStateIssuer
092210000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1821074626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 616788",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328616788",
            "telephone_number": "407-447-7105",
            "fax_number": "407-770-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 W ORANGE BLOSSOM TRL",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327123482",
            "telephone_number": "407-884-2952",
            "fax_number": "407-884-9352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIUFO",
        "first_name": "PHILIP",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA1966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092210000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

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