Mount Dora Medical Institute Inc LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MOUNT DORA MEDICAL INSTITUTE INC LLC

Practice address

1898 N Donnelly St
Mount Dora, FL 32757-2820

Phone

(352) 720-3149

Fax

(352) 800-4054

NPI assigned

Jun 6, 2023

Last updated

Aug 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Caitlyn Paige Whitehead

Title

Administrator

Phone

(352) 445-0778

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1912691593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1898 N DONNELLY ST",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572820",
            "telephone_number": "352-720-3149",
            "fax_number": "352-800-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 N DONNELLY ST",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572820",
            "telephone_number": "352-720-3149",
            "fax_number": "352-800-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT DORA MEDICAL INSTITUTE INC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "CAITLYN",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-445-0778"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayham Mouawad, MD
• William David Moulder, P.T.
• Mount Dora Dental & Dentures (Affordable Dental Care)
• Mount Dora Family Dental PLLC
• Mount Dora Family Practice PA
• Mount Dora Ophthalmology ASC LLC (Mid Florida Surgery Center)
• Mount Dora Physical Therapy Specialists Inc
• Mount Dora Smiles PLLC
• Annette Suzanne Murphy, PA-C
• Constance Murphy, MSW, LCSW

• Internal Medicine Physician in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.