Individual provider Active NPI

Ender Alfonso Urdaneta Torres, SA-C

  • Surgical Assistant
  • Orlando, FL
National Provider Identifier
1891285508
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
18-179 Issued in FL
Practice address
13840 Timberbrooke Dr Apt 101
Orlando, FL 32824-6359
Phone
(407) 690-7799
NPI assigned
May 17, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 18-179 FL Primary

Addresses

Primary practice location

13840 Timberbrooke Dr Apt 101
Orlando, FL 32824-6359

Mailing address

13840 Timberbrooke Dr Apt 101
Orlando, FL 32824-6359
Phone (407) 690-7799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18-179FLMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1891285508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13840 TIMBERBROOKE DR APT 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328246359",
            "telephone_number": "407-690-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13840 TIMBERBROOKE DR APT 101",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328246359",
            "telephone_number": "407-690-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URDANETA TORRES",
        "first_name": "ENDER",
        "middle_name": "ALFONSO",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-17",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "18-179",
            "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 May 17, 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.