W SAND LAKE MEDICAL GROUP LLC (NPI# 1558726257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558726257 |
| Entity Type | Organization |
| Organization Name | W SAND LAKE MEDICAL GROUP LLC |
| Practice Address |
2431 Sand Lake Rd Orlando FL 32809-7641 |
| Mailing Address |
2328 10th Ave N Ste 302 Lake Worth FL 33461-6612 |
| Practice Telephone | 8558768648 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2015-12-22 |
| Authorized Official Name | NICK MATTEO (CFO) |
| Authorized Official Telephone | 5613184430 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2431 SAND LAKE RD |
| City | ORLANDO |
| State | FL |
| Zip Code | 32809-7641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003271719 | Mh At Orlando LLC | Psychologist | 2431 Sand Lake Rd, Orlando, FL 32809-7641 | 2015-12-22 |
| 1083247399 | Brittany Rochelle L'etoile-lopes | Counselor | 2431 Sand Lake Rd, Orlando, FL 32809-7641 | 2020-02-14 |
| 1881051332 | Shaun Barber | Nurse Practitioner | 2431 Sand Lake Rd, Orlando, FL 32809-7641 | 2016-01-27 |
| 1316302029 | Vibro At Orlando LLC | Nurse Practitioner | 2431 Sand Lake Rd, Orlando, FL 32809-7641 | 2015-12-22 |
| 1255796959 | Orlando Diagnostics LLC | Clinical Medical Laboratory | 2431 Sand Lake Rd, Orlando, FL 32809-7641 | 2015-12-22 |
| 1790140408 | Sunrise Detox Orlando LLC | Substance Abuse Rehabilitation Facility | 2431 Sand Lake Rd, Orlando, FL 32809-7641 | 2015-12-22 |
| 1659736361 | Pt At Orlando LLC | Physical Therapist | 2431 Sand Lake Rd, Orlando, FL 32809-7641 | 2015-12-22 |
| 1881059582 | Chiro At Orlando | Chiropractor | 2431 Sand Lake Rd, Orlando, FL 32809-7641 | 2015-12-22 |
| 1114382827 | Acu At Orlando LLC | Acupuncturist | 2431 Sand Lake Rd, Orlando, FL 32809-7641 | 2015-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922634765 | Junie Jean-philippe | Chiropractor | 7130 S Orange Blossom Trail Suite 148, Orlando, FL 32809 | 2020-03-12 |
| 1073030276 | Amanda Wiegert | Counselor | 6000 Lake Ellenor Drive, Orlando, FL 32809 | 2017-08-28 |
| 1780114330 | Fanny Vivas | Counselor | 8000 South Orange Avenue, Suite 111, Orlando, FL 32809 | 2017-06-15 |
| 1588101356 | Coassist Pharmacy, LLC | Pharmacy | 2400 Sand Lake Road, Suite 200, Orlando, FL 32809 | 2017-01-31 |
| 1306203872 | Greidis Villalobos | Counselor | 5957 Estella Way, Orlando, FL 32809 | 2016-01-28 |
| 1891113809 | Orville Mario Morgan | Genetic Counselor, MS | 1220 Evangeline Ave., Orlando, FL 32809 | 2014-04-07 |
| 1669727699 | Hispanic Family Counseling Inc | Social Worker | 6900 S Orange Blossom Trl Ste 402, Orlando, FL 32809 | 2012-07-16 |
| 1548529118 | Laurie Lowe Forbes | Pharmacist | 530 Sunport Lane, Orlando, FL 32809 | 2012-05-16 |
| 1972886307 | Viet H Nguyen | Pharmacist | 7003 Presidents Drive Suite 250, Orlando, FL 32809 | 2011-09-22 |
| 1497042774 | Calren S Wang | Physical Therapy Assistant | 1718 Colleen Dr, Belle Isle, FL 32809 | 2011-07-07 |
| Find all providers in zip 32809 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508975566 | Hector Delfin Barreto-samalot | Internal Medicine | 2205 E Michigan St, Orlando, FL 32806-4944 | 2006-08-30 |
| 1689684730 | Luis F Barroso | Internal Medicine | 1002 N Semoran Blvd, Orlando, FL 32807 | 2006-08-09 |
| 1710359716 | New Choice Healthcare Group | Internal Medicine | 4700 Millenia Blvd, Suite 175, Orlando, FL 32839-6013 | 2015-10-29 |
| 1518140425 | Hanley Pain and Rehabilitation Center Inc | Internal Medicine | 5979 Vineland Rd, Suite 209, Orlando, FL 32819-7800 | 2007-12-13 |
| 1275752131 | Health and Recovery Institute of Central Florida | Internal Medicine | 2205 E Michigan St, Orlando, FL 32806-4944 | 2007-04-25 |
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|---|---|---|---|---|
| 1427685411 | Mark Schellhammer LLC | Internal Medicine | 7151 University Blvd Ste 120, Winter Park, FL 32792-6724 | 2020-03-27 |
| 1619527157 | Amron Vitality and Wellness Center, LLC | Internal Medicine | 6339 Argyle Forest Blvd Ste 3, Jacksonville, FL 32244-6601 | 2019-09-17 |
| 1952769754 | R N Singh Enterprises Pllc | Internal Medicine | 11760 Lynmoor Dr, Riverview, FL 33579-7037 | 2016-02-08 |
| 1518360726 | Family Health Care of Delray, Inc. | Internal Medicine | 7100 S Military Trl, Suite 7126, Lake Worth, FL 33463-7812 | 2014-10-01 |
| 1184043119 | Desert Rose Fl LLC | Internal Medicine | 835 Ardmore Rd, West Palm Beach, FL 33401-7631 | 2014-04-07 |
| 1265851299 | Clear Health of The Palm Beaches | Internal Medicine | 1095 Military Trl Unit 91, Jupiter, FL 33468-5005 | 2014-04-07 |
| 1891128732 | Ashton Pierce Thompson | Internal Medicine | 2449 Ne 13th Ave, Wilton Manors, FL 33305 | 2013-08-14 |
| 1396182630 | Harp Diagnostics LLC | Internal Medicine | 2655 N Ocean Dr, 103, Riviera Beach, FL 33404-4751 | 2013-05-28 |
| 1861717514 | Fanuel Dorilas | Internal Medicine | 1229 Nw 40th Ave, Lauderhill, FL 33313-5801 | 2010-04-06 |
| 1083846034 | Carol S. Rudolph | Internal Medicine | 4949 S Congress Ave Ste B, Lake Worth, FL 33461-4731 | 2009-08-10 |
| 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.