LONGWOOD MEDICAL GROUP PA (NPI# 1235323023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235323023 |
| Entity Type | Organization |
| Organization Name | LONGWOOD MEDICAL GROUP PA |
| Other Organization Name | LONGWOOD CARDIOLOGY PA |
| Practice Address |
450 W State Road 434 Ste 301 Longwood FL 32750-5187 |
| Mailing Address |
450 W State Rd 434 Ste 301 Longwood FL 32750 |
| Practice Telephone | 4077678200 |
| Practice Fax Number | 4077670476 |
| Mailing Telephone | 4077678200 |
| Mailing Fax Number | 4077670476 |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2018-05-01 |
| NPI Deactivation Date | 04/15/2018 |
| NPI Reactivation Date | 2018-05-01 |
| Authorized Official Name | MS. ALISA MARIE CHARACTER (BILLING OFFICE SUPERVISOR) |
| Authorized Official Telephone | 4077678200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | ME79324 | FL | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
ME78066 | FL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Longwood Cardiology PA | Former Legal Business Name - Organization |
| Street Address |
450 W STATE ROAD 434 STE 301 |
| City | LONGWOOD |
| State | FL |
| Zip Code | 32750-5187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061330 | Wasim Ahmar | Internal Medicine | 450 W State Road 434, Ste 301, Longwood, FL 32750-5187 | 2005-05-24 |
| 1902353485 | Batson Family Health Center for Wellness,p.a. | Clinic/Center | 450 W State Road 434, Suite 2020, Longwood, FL 32750-5118 | 2016-09-01 |
| 1083001564 | Urgent Care of Longwood | Clinic/Center | 450 W State Road 434, Suite 1010, Longwood, FL 32750-5118 | 2015-04-22 |
| 1295053585 | Volusia Psychiatry, Inc | Psychiatry & Neurology | 450 W State Road 434, Longwood, FL 32750-5187 | 2010-05-11 |
| 1134143233 | Bassam Amawi | Psychiatry & Neurology | 450 W State Road 434, Longwood, FL 32750-5187 | 2006-07-26 |
| 1285686428 | Khalid Yaqoob | Internal Medicine | 450 W State Road 434, Ste 301, Longwood, FL 32750-5187 | 2006-05-16 |
| 1982673414 | Orlando Diagnostic Center Inc | Radiologic Technologist | 450 W State Road 434, Suite 1020, Longwood, FL 32750-5118 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902420920 | Prn Speech Pathologists | Speech-Language Pathologist | 1704 N. Ronald Reagan Blvd, Longwood, FL 32750 | 2020-06-05 |
| 1831743368 | Shamar Anthony Marston | Nurse Anesthetist, Certified Registered | 555 W Fl - 434, Longwood, FL 32750 | 2019-08-01 |
| 1538639125 | Omega Healthcare Solutions, LLC | Case Management | 160 W. Evergreen Avenue Suite 290, Longwood, FL 32750 | 2018-11-27 |
| 1013416080 | Samantha Jane Roberts | Specialist/Technologist, Other | 163 W Bay Ave, Longwood, FL 32750 | 2018-02-06 |
| 1508375874 | Cassandra Thompson-bailey | Nurse Practitioner | 600 N Us Hwy 17 92, Suite 124, Longwood, FL 32750 | 2017-09-29 |
| 1740799535 | Cornerstone Longwood Leasing, LLC | Assisted Living Facility | 480 E. Church Ave., Longwood, FL 32750 | 2017-09-25 |
| 1659890523 | Melissa Shoshana Vigerito | Marriage & Family Therapist | 978 Douglas Ave. Suite 100, Altamonte Springs, FL 32750 | 2017-09-12 |
| 1619498185 | Calm Relief, LLC | Massage Therapist | 1855 W State Road 434, Ste 253, Longwood, FL 32750 | 2017-07-05 |
| 1497145148 | Caitlin Rhea Hilligas | Counselor | 300 N Ronald Reagan Blvd Ste 302, Longwood, FL 32750 | 2015-02-03 |
| 1316344054 | James David Rawlins Jr. | Dentist | 1250 W.s.r 434 Ste. 1008, Longwood, FL 32750 | 2014-11-24 |
| Find all providers in zip 32750 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437765443 | Premier Cardiovascular Center, LLC | Internal Medicine | 450 W State Road 434 Ste 2010, Longwood, FL 32750-5187 | 2020-09-16 |
| 1447782875 | Heart Vein and Vascular LLC | Internal Medicine | 2170 W State Road 434 Ste 190, Longwood, FL 32779-4976 | 2017-04-03 |
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| 1679199236 | Tallahassee Memorial Healthcare Inc | Internal Medicine | 877 3rd St Ste 3, Chipley, FL 32428-1855 | 2020-06-19 |
| 1972123701 | Heart Clinic of Central Florida LLC | Internal Medicine | 52 Riley Rd # 429, Celebration, FL 34747-5420 | 2020-04-22 |
| 1205465440 | Cardiology Group Panel LLC | Internal Medicine | 201 Nw 82nd Ave Ste 405, Plantation, FL 33324-1883 | 2020-04-08 |
| 1346876745 | H & D Cardiology, Pa | Internal Medicine | 1879 Nightingale Ln Ste B2, Tavares, FL 32778-4363 | 2020-03-17 |
| 1427690775 | The Cardiac and Vascular Institute Ambulatory Surgery Center | Internal Medicine | 4645 Nw 8th Ave Ste 10, Gainesville, FL 32605-4688 | 2019-10-08 |
| 1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
| 1023660255 | Florida Medical Specialists LLC | Internal Medicine | 1250 S Tamiami Trl Ste 300, Sarasota, FL 34239-2221 | 2019-07-09 |
| 1962064493 | Ckk Medical LLC | Internal Medicine | 6600 Sw State Road 200 # 200, Ocala, FL 34476-5554 | 2019-07-04 |
| 1952968026 | Jose Miguel Simo | Internal Medicine | 3347 S State Road 7 Ste 205, Wellington, FL 33449-8148 | 2019-05-23 |
| 1114488400 | Cfl Care of Fl IIi, LLC | Internal Medicine | 2 S Biscayne Blvd Ste 3760, Miami, FL 33131-1815 | 2019-03-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.