Silver Star Family Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

30010964034 Issued in FL

Legal business name

SILVER STAR FAMILY MEDICINE

Practice address

1202 E Silver Star Rd
Ocoee, FL 34761-2460

Phone

(407) 656-7866

Fax

(407) 656-3032

NPI assigned

Oct 21, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Vilmary Vazquez, NCMA

Title

Credentialing Agent

Phone

(407) 656-7866

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Alex C Perdomo, MD

  • Family Medicine Physician
  • Ocoee, FL
  • NPI 1548362627
  Medicare reassignment

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1831499060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E SILVER STAR RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347612460",
            "telephone_number": "407-656-7866",
            "fax_number": "407-656-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E SILVER STAR RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347612460",
            "telephone_number": "407-656-7866",
            "fax_number": "407-656-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER STAR FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "VILMARY",
        "authorized_official_title_or_position": "CREDENTIALING AGENT",
        "authorized_official_telephone_number": "407-656-7866",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NCMA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "30010964034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Ian Silberstein, D.C.
• Alan Silva
• Calvin Silva
• Juliana Gabriela Palma Silveira, PT,CLT
• Silver Bend Care
• Flavia Silverio
• Shakana Lashea Simmons-Hall, APRN
• Fabienne E Simon
• Simonmed Imaging Florida LLC
• Eshmalini Singh

• Primary Care Clinic/Center in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.