NPIMap

Organization Active NPI

Medical Village Healthcare Group

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1861630626
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME81287 Issued in FL
Legal business name
MEDICAL VILLAGE HEALTHCARE GROUP
Practice address
1462 W Oak Ridge Rd
Orlando, FL 32809-3905
Phone
(407) 888-6990
Fax
(407) 888-3310
NPI assigned
Jan 31, 2009
Organization subpart
Yes
Parent organization
MEDICAL VILLAGE HEALTHCARE GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Authorized official

Name
Dr. Khalid Manzur, MDNPI 1447223193
Title
President
Phone
(407) 888-6990

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X ME81287 FL
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X ME81287 FL Primary

Addresses

Primary practice location

1462 W Oak Ridge Rd
Orlando, FL 32809-3905

Mailing address

816 W Oak St
Kissimmee, FL 34741-6625
Phone (407) 944-9777

Other identifiers 2

IdentifierTypeStateIssuer
1376516575OtherFLINDIVIDUAL PROVIDER NPI
1447223193OtherFLINDIVIDUAL PROVIDER NPI

National Provider Directory

National Provider Directory
Tax ID family
Medical Village Healthcare Group2 organizations share this tax ID, including this one
Part of
Medical Village Healthcare Group

Other organizations with this tax ID 1

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

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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1233360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233532800000",
    "number": "1861630626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347416625",
            "telephone_number": "407-944-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 W OAK RIDGE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328093905",
            "telephone_number": "407-888-6990",
            "fax_number": "407-888-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL VILLAGE HEALTHCARE GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL VILLAGE HEALTHCARE GROUP",
        "enumeration_date": "2009-01-31",
        "last_updated": "2009-02-02",
        "status": "A",
        "authorized_official_last_name": "MANZUR",
        "authorized_official_first_name": "KHALID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-888-6990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME81287",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME81287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NPI",
            "identifier": "1376516575",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NPI",
            "identifier": "1447223193",
            "state": "FL"
        }
    ],
    "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 Feb 2, 2009; 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.