NPIMap

Organization Active NPI

Medical Injury Care Provider Network

  • Surgery Physician
  • Orlando, FL
National Provider Identifier
1851861348
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MEDICAL INJURY CARE PROVIDER NETWORK
Practice address
1805 W Colonial Dr Ste a
Orlando, FL 32804-7011
Phone
(407) 578-9142
NPI assigned
Nov 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Authorized official

Name
Owen D Fraser, MDNPI 1982760690
Title
President
Phone
(407) 351-1095

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1805 W Colonial Dr Ste a
Orlando, FL 32804-7011

Mailing address

1805 W Colonial Dr Ste a
Orlando, FL 32804-7011
Phone (407) 578-9142

Other practice location 1

510 Highway 466 Ste 104B
Lady Lake, FL 32159-6341
Phone (407) 578-9142

National Provider Directory

National Provider Directory

Locations

510 Highway 466
Ste 104B
Lady Lake, FL 32159
Phone (407) 578-9142

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1851861348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 W COLONIAL DR STE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328047011",
            "telephone_number": "407-578-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 W COLONIAL DR STE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328047011",
            "telephone_number": "407-578-9142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Highway 466 Ste 104B",
            "address_purpose": "LOCATION",
            "city": "Lady Lake",
            "state": "FL",
            "postal_code": "321596341",
            "country_code": "US",
            "telephone_number": "407-578-9142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL INJURY CARE PROVIDER NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-351-1095",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 28, 2018; 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.