Organization Active NPI

Aloma Park OB/GYN PA

  • Obstetrics & Gynecology Physician
  • Winter Park, FL
National Provider Identifier
1952375388
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OS0005626 Issued in FL
Legal business name
ALOMA PARK OB/GYN PA
Practice address
1925 Mizell Ave
Ste 104
Winter Park, FL 32792
Phone
(407) 657-4407
Fax
(407) 657-4669
NPI assigned
Feb 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Bernard Thomas Despres, DONPI 1356317283
Title
President
Phone
(407) 657-4407

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OS0005626 FL Primary

Addresses

Primary practice location

1925 Mizell Ave
Ste 104
Winter Park, FL 32792

Mailing address

1925 Mizell Ave
Ste 104
Winter Park, FL 32792
Phone (407) 657-4407

National Provider Directory

National Provider Directory

Locations

1925 Mizell Ave
Ste 104
Winter Park, FL 32792
Phone (407) 628-3073

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952375388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE",
            "address_2": "STE 104",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-657-4407",
            "fax_number": "407-657-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE",
            "address_2": "STE 104",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-657-4407",
            "fax_number": "407-657-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALOMA PARK OB/GYN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DESPRES",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-657-4407",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS0005626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.