PARK AVE MEDICAL GROUP (NPI# 1326308719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326308719 |
| Entity Type | Organization |
| Organization Name | PARK AVE MEDICAL GROUP |
| Other Organization Name | PARK AVE MEDICAL GROUP |
| Practice Address |
424 N Park Ave Apopka FL 32712-4152 |
| Practice Telephone | 4078860611 |
| Practice Fax Number | 4078862817 |
| Mailing Telephone | 4078860611 |
| Mailing Fax Number | 4078862817 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |
| Authorized Official Name | DR. ADLAI STEVEN GREEN (BOSS) |
| Authorized Official Telephone | 4078860611 |
| Authorized Official Credential | DC |
| Is Organization Subpart | Y |
| Parent Organization Name | APOPKA WELLNESS CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Park Ave Medical Group | Doing Business As Name - Organization |
| Street Address |
424 N PARK AVE |
| City | APOPKA |
| State | FL |
| Zip Code | 32712-4152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760481063 | Adlai Steven Green | Chiropractor | 424 N Park Ave, Apopka, FL 32712-4152 | 2005-07-19 |
| 1144643362 | Pure Natural Medicine, Pa | Acupuncturist | 424 N Park Ave, Apopka, FL 32712-4152 | 2014-01-23 |
| 1013253095 | Michael Everett Palmer II | Physician Assistant | 424 N Park Ave, Apopka, FL 32712-4152 | 2012-12-20 |
| 1346420627 | Apopka Wellness Center,inc. | Family Medicine | 424 N Park Ave, Apopka, FL 32712-4152 | 2007-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003428467 | Pamella Omelda Odoms-brown | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 541 Shirley Dr., Apopka, FL 32712 | 2020-08-18 |
| 1871158741 | Adventist Health System /sunbelt, Inc. | Clinic/Center | 1520 W. Orange Blossom Trail, Apopka, FL 32712 | 2019-05-07 |
| 1477088433 | Kim Johnson | Counselor | 1041 Lake Francis Drive, Apopka, FL 32712 | 2017-04-27 |
| 1497290811 | Yasmine Mollings | Behavior Technician | 1741 Parkglen Circle, Apopka, FL 32712 | 2016-12-20 |
| 1316391170 | Infinity Dental LLC | Dentist | 1450 N. Rock Springs Rd, Apopka, FL 32712 | 2016-04-19 |
| 1518368323 | Eleanor Mccall Hawthorne | Counselor | 1928 Bluff Oak St., Apopka, FL 32712 | 2014-09-11 |
| 1497092613 | Anayanzi Annette Simpson | Social Worker | 523 Wekiva Commons Circle #4, Apopka, FL 32712 | 2013-01-08 |
| 1275884553 | Marcia Annette Bryan | Nursing Home Administrator | 957 Rock Creek Street, Apopka, FL 32712 | 2012-09-26 |
| 1790067460 | Benjamin W Song | Dentist | 2053 Palm Vista Drive, Apopka, FL 32712 | 2011-09-19 |
| 1235367400 | Adventist Home Care Services | Home Health | 1109 Tall Pine Drive, Apopka, FL 32712 | 2009-06-26 |
| Find all providers in zip 32712 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548599095 | Luon Van Ta | General Practice | 440 Chinahill Ct, Apopka, FL 32712-2813 | 2009-12-11 |
| 1538173786 | George Michel Elias | General Practice | 63 E 3rd St, Apopka, FL 32703-4235 | 2006-07-27 |
| 1093735805 | Theresa Marie Oakley | General Practice | 63 E 3rd St, Apopka, FL 32703-4235 | 2006-07-21 |
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| 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.