NPIMap

Organization Active NPI

Orlando Infectious Disease Consultancy Services PL

  • Infectious Disease Physician
  • Kissimmee, FL
National Provider Identifier
1881769685
Registry record updated Dec 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME88164 Issued in FL
Legal business name
ORLANDO INFECTIOUS DISEASE CONSULTANCY SERVICES PL
Practice address
1182 Cypress Glen Cir
Kissimmee, FL 34741-7560
Phone
(407) 350-5917
Fax
(407) 350-5928
NPI assigned
Nov 21, 2006
Last updated
Dec 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2014

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

Authorized official

Name
Dr. Mariam Adam Esat, M.D.NPI 1982681185
Title
President
Phone
(407) 350-5917

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: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME88164 FL
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X ME88164 FL Primary

Addresses

Primary practice location

1182 Cypress Glen Cir
Kissimmee, FL 34741-7560

Mailing address

4156 Brookmyra Dr
Orlando, FL 32837-5109
Phone (321) 228-0073

Other identifiers 2

IdentifierTypeStateIssuer
268403900MedicaidFL
DF5048OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070320000594 FL Part B Supplier - Clinic/Group Practice 3971606575 Receives reassigned benefits from 7 practitioners
Practice locations: Kissimmee, FL

National Provider Directory

National Provider Directory
Tax ID family
Orlando Infectious Disease C2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

410 Lionel Way
#203A
Davenport, FL 33837
Phone (407) 350-5924

1182 Cypress Glen Cir
Kissimmee, FL 34741
Phone (407) 303-3832

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419552000000",
    "number": "1881769685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4156 BROOKMYRA DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328375109",
            "telephone_number": "321-228-0073",
            "fax_number": "407-350-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 CYPRESS GLEN CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417560",
            "telephone_number": "407-350-5917",
            "fax_number": "407-350-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLANDO INFECTIOUS DISEASE CONSULTANCY SERVICES PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2014-12-26",
        "status": "A",
        "authorized_official_last_name": "ESAT",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-350-5917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME88164",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME88164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268403900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF5048",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2014; 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.