PELICAN BEACH INC (NPI# 1871503797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871503797 |
| Entity Type | Organization |
| Organization Name | PELICAN BEACH INC |
| Other Organization Name | 33RD STREET FAMILY MEDICAL CENTER |
| Practice Address |
4382 Lb Mcleod Rd Orlando FL 32811 |
| Practice Telephone | 4076480076 |
| Practice Fax Number | 4076483666 |
| Mailing Telephone | 4076480076 |
| Mailing Fax Number | 4076483666 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2014-04-15 |
| Authorized Official Name | MRS. VILMARY VAZQUEZ (HEALTHCARE ADMINISTRATOR) |
| Authorized Official Telephone | 4076480076 |
| Authorized Official Credential | NCMA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PTAN | DB888A | 01 |
| Other Name | Type Code |
|---|---|
| 33rd Street Family Medical Center | Doing Business As Name - Organization |
| Street Address |
4382 LB MCLEOD RD |
| City | ORLANDO |
| State | FL |
| Zip Code | 32811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275731234 | Karina Franco | Family Medicine | 4382 Lb Mcleod Rd, Orlando, FL 32811 | 2007-07-10 |
| 1659460764 | Ruben Perez | Family Medicine | 4382 Lb Mcleod Rd, Orlando, FL 32811 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922640168 | Carlo Lavern Shaw | Counselor | 6150 Metro West Blvd Suite 103, Orlando, FL 32811 | 2019-10-09 |
| 1639734791 | Malissa Brown | Home Health | 5208 Greenery Ct, Orlando, FL 32811 | 2019-05-04 |
| 1619431665 | Health Care Center for The Homeless Inc | Pharmacy | 4426 Old Winter Garden Rd, Orlando, FL 32811 | 2019-01-24 |
| 1649763178 | Marie Alexandra Senat I | Adult Companion | 640 Grandiflora Drive, Orlando, FL 32811 | 2018-06-09 |
| 1851893309 | Next Level Physiotherapy and Performance | Physical Therapist | 4700 Lb Mcleod Rd, Orlando, FL 32811 | 2018-03-01 |
| 1447798681 | Stateserv Medical | Durable Medical Equipment & Medical Supplies | 4205 Sw 34th Street, Orlando, FL 32811 | 2017-02-08 |
| 1386054161 | Leondra Foster | Home Health | 4787 King Cole Blvd, Orlando, FL 32811 | 2014-05-02 |
| 1790115681 | Calvin Collins Jr. | Internal Medicine | 4403 Vineland Rd, Suite B5, Orlando, FL 32811 | 2013-11-14 |
| 1043514458 | Legacy V Medical | Durable Medical Equipment & Medical Supplies | 3113 Willie Mays Pkwy, Ste.1100-b, Orlando, FL 32811 | 2010-12-28 |
| 1477871440 | Rm Toussaint Md LLC | Surgery | 4600 S. Kirkman Road, # 218, Orlando, FL 32811 | 2010-05-14 |
| Find all providers in zip 32811 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194228668 | Urgent Family Clinic, LLC | Clinic/Center | 1130 S Semoran Blvd Ste F, Orlando, FL 32807-1457 | 2018-03-12 |
| 1326541897 | Urgent Family Clinic, LLC | Clinic/Center | 11601 S Orange Blossom Trl Ste 101, Orlando, FL 32837-9437 | 2018-03-12 |
| 1134620792 | Lotus Family Health LLC | Clinic/Center | 1803 Park Center Dr Ste 111, Orlando, FL 32835-6216 | 2018-02-27 |
| 1487190609 | Bones Medical Group | Clinic/Center | 8288 Lee Vista Blvd Ste A, Orlando, FL 32829-8071 | 2017-01-11 |
| 1568833093 | Advantage Medical Group LLC | Clinic/Center | 1111-b S Semoran Blvd, Orlando, FL 32807-1480 | 2015-10-09 |
| 1497168173 | Doctors At Home Tri County | Clinic/Center | 11954 Narcoossee Rd Ste 2 #504, Orlando, FL 32832-6998 | 2014-06-10 |
| 1700209400 | Orange Ave Consulting | Clinic/Center | 2106 N Orange Ave, Orlando, FL 32804-5535 | 2014-01-31 |
| 1750621538 | Florida Family Physicians | Clinic/Center | 2840 N Hiawassee Rd, Suite 428, Orlando, FL 32818-3319 | 2013-02-15 |
| 1629322755 | Growing Together Pediatrics, LLC | Clinic/Center | 5164 S. Conway Rd, Orlando, FL 32819-1252 | 2012-10-26 |
| 1558622068 | Gutteridge Jeancharles, Md, Pa | Clinic/Center | 6388 Silver Star Rd Ste 2h, Orlando, FL 32818-3235 | 2012-05-31 |
| Find all providers in ORLANDO | ||||
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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.