NPIMap

Organization Active NPI

Patient Medical Center of Florida Inc

  • Family Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1891206504
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PATIENT MEDICAL CENTER OF FLORIDA INC
Practice address
819 N Central Ave
Kissimmee, FL 34741
Phone
(407) 288-8242
Fax
(407) 490-1309
NPI assigned
Oct 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Authorized official

Name
Mr. Luis Mercado
Title
Vice President
Phone
(407) 288-8242

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

819 N Central Ave
Kissimmee, FL 34741

Mailing address

819 N Central Ave
Kissimmee, FL 34741-5027

Other identifiers 1

IdentifierTypeStateIssuer
023559900MedicaidFL

National Provider Directory

National Provider Directory

Locations

819 N Central Ave
Kissimmee, FL 34741
Phone (407) 288-8242

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1891206504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N CENTRAL AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N CENTRAL AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34741",
            "telephone_number": "407-288-8242",
            "fax_number": "407-490-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATIENT MEDICAL CENTER OF FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-20",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "MERCADO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "407-288-8242",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023559900",
            "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 Jul 5, 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.