NPIMap

Organization Active NPI

Florida ENT Adult & Pediatrics, PA

  • Medical Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1972905099
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PAT 9108176 Issued in FL
Legal business name
FLORIDA ENT ADULT & PEDIATRICS, PA
Practice address
1162 Cypress Glen Cir
Kissimmee, FL 34741-7560
Phone
(407) 343-9006
Fax
(407) 343-0999
NPI assigned
Sep 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
Omar Fadhli, MDNPI 1922160951
Title
Owner
Phone
(407) 343-9006

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
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PAT 9108176 FL Primary

Addresses

Primary practice location

1162 Cypress Glen Cir
Kissimmee, FL 34741-7560

Mailing address

1162 Cypress Glen Cir
Kissimmee, FL 34741-7560
Phone (407) 343-9006

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1972905099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162 CYPRESS GLEN CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417560",
            "telephone_number": "407-343-9006",
            "fax_number": "407-343-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162 CYPRESS GLEN CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417560",
            "telephone_number": "407-343-9006",
            "fax_number": "407-343-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA ENT ADULT & PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "FADHLI",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-343-9006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PAT 9108176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.