Plaza de la Salud PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME105191 Issued in FL

Legal business name

PLAZA DE LA SALUD PLLC

Practice address

2635 Boggy Creek Rd
Kissimmee, FL 34744-4101

Phone

(239) 314-4600

NPI assigned

Oct 25, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Gerardo Feliciano, M.D

Title

Member

Phone

(239) 314-4600

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1942500855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 BOGGY CREEK RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444101",
            "telephone_number": "239-314-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 BOGGY CREEK RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444101",
            "telephone_number": "239-314-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA DE LA SALUD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "FELICIANO",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "239-314-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME105191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN DR FELICIANO",
            "identifier": "DE030Y",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN PLAZA DE LA SALUD",
            "identifier": "EZ306A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR GERARDO FELICIANO NPI",
            "identifier": "1942283429",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4240180",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "DE030Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.