NPIMap

Organization Active NPI

Metcare of Deland

  • Family Medicine Physician
  • Deland, FL
National Provider Identifier
1851776868
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
METCARE OF DELAND
Practice address
929 N Spring Garden Ave
Suite 170
Deland, FL 32720-0900
Phone
(561) 805-8530
Fax
(502) 508-4773
NPI assigned
Jul 21, 2015
Organization subpart
Yes
Parent organization
METROPOLITAN HEALTH NETWORKSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Authorized official

Name
Gemma Rosello
Title
Vice President
Phone
(305) 500-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

929 N Spring Garden Ave
Suite 170
Deland, FL 32720-0900

Mailing address

6101 Blue Lagoon Dr
Suite 400
Miami, FL 33126-2055
Phone (305) 500-2114

Other identifiers 1

IdentifierTypeStateIssuer
CX415BOtherFLMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
Metcare of Florida Inc29 organizations share this tax ID, including this one
Part of
Metropolitan Health Networks LT Blue Zone

Other organizations with this tax ID 28

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

View all 28

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1851776868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR",
            "address_2": "SUITE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262055",
            "telephone_number": "305-500-2114",
            "fax_number": "305-370-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 N SPRING GARDEN AVE",
            "address_2": "SUITE 170",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327200900",
            "telephone_number": "561-805-8530",
            "fax_number": "502-508-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METCARE OF DELAND",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METROPOLITAN HEALTH NETWORKS",
        "enumeration_date": "2015-07-21",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "ROSELLO",
        "authorized_official_first_name": "GEMMA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "305-500-2000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CX415B",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.