Active NPI
Dynasty Health Group Center
- Family Medicine Physician
- Kissimmee, FL
National Provider Identifier
1902655657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- DYNASTY HEALTH GROUP CENTER
- Practice address
- 102 Redwing CT
Kissimmee, FL 34759-5110 - Phone
- (786) 712-5523
- NPI assigned
- May 15, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Woodson Donacien
- Title
- Ceo
- Phone
- (786) 712-5523
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
102 Redwing CT
Kissimmee, FL 34759-5110
Mailing address
102 Redwing CT
Kissimmee, FL 34759-5110
Phone (786) 712-5523
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715731200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1715731200000",
"number": "1902655657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 REDWING CT",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347595110",
"telephone_number": "786-712-5523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 REDWING CT",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347595110",
"telephone_number": "786-712-5523"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DYNASTY HEALTH GROUP CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2024-05-15",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A",
"authorized_official_last_name": "DONACIEN",
"authorized_official_first_name": "WOODSON",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "786-712-5523"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.