NPIMap

Organization Active NPI

Prime Health of Central Florida

  • Pediatric Gastroenterology Physician
  • Daytona Beach, FL
National Provider Identifier
1902465610
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
Legal business name
PRIME HEALTH OF CENTRAL FLORIDA
Practice address
517 Health Blvd
Daytona Beach, FL 32114-1493
Phone
(386) 256-4031
Fax
(386) 256-7151
NPI assigned
Jun 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
Osman Ahmad, MDNPI 1467719492
Title
Executive Director
Phone
(321) 274-7519

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0206X Primary

Addresses

Primary practice location

517 Health Blvd
Daytona Beach, FL 32114-1493

Mailing address

608 Maitland Ave
Altamonte Springs, FL 32701-6834
Phone (386) 271-2273

Other practice location 1

7758 Wallace Rd Ste Vi
Orlando, FL 32819-7219
Phone (386) 256-4031

Other practice location 2

608 Maitland Ave
Altamonte Springs, FL 32701-6834
Phone (386) 256-4031

Other names 1

  • ADVANCED PEDIATRIC GASTROENTEROLOGY SPECIALISTS Doing business as

National Provider Directory

National Provider Directory

Locations

7758 Wallace Rd
Ste Vi
Orlando, FL 32819
Phone (386) 256-4031

Practitioners & affiliated clinicians

Practitioners 2

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": "1559865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1902465610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 MAITLAND AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327016834",
            "telephone_number": "386-271-2273",
            "fax_number": "386-271-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 HEALTH BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141493",
            "telephone_number": "386-256-4031",
            "fax_number": "386-256-7151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7758 Wallace Rd Ste Vi",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328197219",
            "country_code": "US",
            "telephone_number": "386-256-4031",
            "fax_number": "386-256-7151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "608 Maitland Ave",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327016834",
            "country_code": "US",
            "telephone_number": "386-256-4031",
            "fax_number": "386-256-7151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME HEALTH OF CENTRAL FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "OSMAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-274-7519",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCED PEDIATRIC GASTROENTEROLOGY SPECIALISTS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ADVANCED PEDIATRIC GASTROENTEROLOGY SPECIALISTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.