Organization Active NPI

GFM Family Medicine

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1902094725
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GFM FAMILY MEDICINE
Practice address
5575 S Semoran Blvd
Suite 23
Orlando, FL 32822-1747
Phone
(407) 275-0080
Fax
(407) 275-8775
NPI assigned
Oct 5, 2007
Last updated
Feb 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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

Authorized official

Name
Mr. Edward Amendola
Title
Billing Manager
Phone
(407) 275-0080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

5575 S Semoran Blvd
Suite 23
Orlando, FL 32822-1747

Mailing address

5575 S Semoran Blvd
Suite 23
Orlando, FL 32822-1747
Phone (407) 275-0080

Other identifiers 4

IdentifierTypeStateIssuer
51801387OtherFLAETNA PROVIDER NUMBER
ME61279OtherFLFLORIDA STATE LICENSE
BD4403161OtherFLD.E.A. NUMBER
28143OtherFLBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1902094725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 S SEMORAN BLVD",
            "address_2": "SUITE 23",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328221747",
            "telephone_number": "407-275-0080",
            "fax_number": "407-275-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 S SEMORAN BLVD",
            "address_2": "SUITE 23",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328221747",
            "telephone_number": "407-275-0080",
            "fax_number": "407-275-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GFM FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "AMENDOLA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "407-275-0080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "51801387",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA STATE LICENSE",
            "identifier": "ME61279",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "D.E.A. NUMBER",
            "identifier": "BD4403161",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "28143",
            "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 14, 2008; 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.