Organization Active NPI

Endocrinology & Diabetes Specialist, LLC

  • Multi-Specialty Clinic/Center
  • Orlando, FL
National Provider Identifier
1942065792
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ENDOCRINOLOGY & DIABETES SPECIALIST, LLC
Practice address
1743 Park Center Dr Ste 300
Orlando, FL 32835-7621
Phone
(703) 862-4403
NPI assigned
Feb 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Saima AliNPI 1932185733
Title
Ceo
Phone
(703) 862-4403

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
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1743 Park Center Dr Ste 300
Orlando, FL 32835-7621

Mailing address

501 S Kirkman Rd # 616587
Orlando, FL 32811-2007

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240815000227 FL Part B Supplier - Clinic/Group Practice 7113465691 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

1743 Park Center Dr
Ste 300
Orlando, FL 32835
Phone (407) 378-7169

501 S Kirkman Rd
#616587
Orlando, FL 32811

Practitioners & affiliated clinicians

Practitioners 1

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": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1942065792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S KIRKMAN RD # 616587",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328112007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 PARK CENTER DR STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328357621",
            "telephone_number": "703-862-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY & DIABETES SPECIALIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "SAIMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-862-4403"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.