Northside Family Practice, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHSIDE FAMILY PRACTICE, INC.

Practice address

1718 Lexington Green LN
Sanford, FL 32771-1018

Phone

(407) 268-9661

Fax

(407) 268-9664

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Suree Vyas

Title

Administrator

Phone

(407) 830-1975

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1942245550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W SABAL PALM PL",
            "address_2": "SUITE 300",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327793639",
            "telephone_number": "407-260-1137",
            "fax_number": "407-332-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 LEXINGTON GREEN LN",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711018",
            "telephone_number": "407-268-9661",
            "fax_number": "407-268-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE FAMILY PRACTICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "VYAS",
        "authorized_official_first_name": "SUREE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-830-1975",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.