Organization Active NPI

Florida Medical Center PL

  • Internal Medicine Physician
  • Winter Haven, FL
National Provider Identifier
1972550408
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0074646 Issued in FL
Legal business name
FLORIDA MEDICAL CENTER PL
Practice address
308 Avenue C NE
Winter Haven, FL 33881-4558
Phone
(863) 294-7959
Fax
(863) 294-9338
NPI assigned
May 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Dr. Ashok G Reddy, M.DNPI 1679554893
Title
Owner
Phone
(863) 294-7959

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0074646 FL Primary

Addresses

Primary practice location

308 Avenue C NE
Winter Haven, FL 33881-4558

Mailing address

9733 Wyland CT
Windermere, FL 34786-5610
Phone (863) 294-7959

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071109000129 FL Part B Supplier - Clinic/Group Practice 6800984873 Receives reassigned benefits from 1 practitioner
Practice locations: Winter Haven, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0974717Florida Medical Center PL308 Avenue C N E, Winter Haven, FL 33881Certificate of waiverJun 14, 2028

National Provider Directory

National Provider Directory

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": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1972550408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9733 WYLAND CT",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347865610",
            "telephone_number": "863-294-7959",
            "fax_number": "863-294-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 AVENUE C NE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814558",
            "telephone_number": "863-294-7959",
            "fax_number": "863-294-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MEDICAL CENTER PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "ASHOK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-294-7959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0074646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.