NPIMap

Organization Active NPI

Orlando Family Physicians, LLC

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1861146201
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ORLANDO FAMILY PHYSICIANS, LLC
Practice address
8408 N Grady Ave
Tampa, FL 33614-1907
Phone
(813) 885-9091
Fax
(813) 324-1133
NPI assigned
Feb 4, 2022
Organization subpart
Yes
Parent organization
ORLANDO FAMILY PHYSICIANS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
Penelope Kokkinides
Title
Chief Administrative Officer
Phone
(201) 270-7825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

8408 N Grady Ave
Tampa, FL 33614-1907

Mailing address

6900 Tavistock Lakes Blvd Ste 300
Orlando, FL 32827-7592
Phone (321) 332-6947

Other practice location 1

5051 66th St N
St Petersburg, FL 33709-3119
Phone (727) 800-6708

Other names 1

  • Waters Medical Clinic 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
10D1041032Orlando Family Physicians, LLC8408 N Grady Ave, Tampa, FL 33614Certificate of waiverMay 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Orlando Family Physicians LLC22 organizations share this tax ID, including this one
Part of
Orlando Family Physicians LLC

Other organizations with this tax ID 21

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

View all 21

Locations

5051 66th St N
St Petersburg, FL 33709
Phone (727) 800-6708

8408 N Grady Ave
Tampa, FL 33614
Phone (813) 885-9091

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1861146201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 TAVISTOCK LAKES BLVD STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277592",
            "telephone_number": "321-332-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8408 N GRADY AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336141907",
            "telephone_number": "813-885-9091",
            "fax_number": "813-324-1133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5051 66th St N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337093119",
            "country_code": "US",
            "telephone_number": "727-800-6708",
            "fax_number": "813-324-1133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORLANDO FAMILY PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORLANDO FAMILY PHYSICIANS, LLC",
        "enumeration_date": "2022-02-04",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "KOKKINIDES",
        "authorized_official_first_name": "PENELOPE",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "201-270-7825"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waters Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waters Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.