Organization Active NPI

Dynasty Health Group Center

  • Family Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1902655657
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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

Updated by the provider on May 15, 2024

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.