NPIMap

Organization Active NPI

Careconnectmd Florida P.a.

  • Geriatric Medicine (Internal Medicine) Physician
  • Jacksonville, FL
National Provider Identifier
1912632886
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
CARECONNECTMD FLORIDA P.A.
Practice address
10151 Deerwood Park Blvd Ste 250
Jacksonville, FL 32256-0566
Phone
(888) 789-9585
Fax
(562) 803-4500
NPI assigned
Jul 23, 2022
Last updated
Aug 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Authorized official

Name
Orlando Collado Jr., MDNPI 1205964947
Title
Owner
Phone
(888) 789-9585

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
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

10151 Deerwood Park Blvd Ste 250
Jacksonville, FL 32256-0566

Mailing address

3090 Bristol St Ste 200
Costa Mesa, CA 92626-3061
Phone (887) 899-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220809000521 FL Part B Supplier - Clinic/Group Practice 7911389838 Receives reassigned benefits from 107 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 108

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.

View all 108

NPI Registry JSON

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

{
    "created_epoch": "1658534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1912632886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 BRISTOL ST STE 200",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263061",
            "telephone_number": "887-899-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 DEERWOOD PARK BLVD STE 250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560566",
            "telephone_number": "888-789-9585",
            "fax_number": "562-803-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECONNECTMD FLORIDA P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-23",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "COLLADO",
        "authorized_official_first_name": "ORLANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-789-9585",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.