NUTMEG HOLDINGS LLC (NPI# 1619132867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619132867 |
| Entity Type | Organization |
| Organization Name | NUTMEG HOLDINGS LLC |
| Other Organization Name | LAKE BALDWIN MEDICAL |
| Practice Address |
1459 Lake Baldwin Ln Suite A Orlando FL 32814-6741 |
| Mailing Address |
Po Box 149374 Orlando FL 32814-9374 |
| Practice Telephone | 4078933905 |
| Practice Fax Number | 4078933906 |
| Mailing Telephone | 4078933905 |
| Mailing Fax Number | 4078933906 |
| Enumeration Date | 2008-07-26 |
| Last Update Date | 2012-03-09 |
| Authorized Official Name | S RAFIK BOUAZIZ (MANAGER / DIRECTOR) |
| Authorized Official Telephone | 4078933905 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| LAKE BALDWIN MEDICAL | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | NUTMEG HOLDINGS LLC | 7 School Street, Suite B, Jewett City, CT 06351 |
| North Carolina Corporations | Nutmeg Holdings LLC | 1125 E. Morehead St. Ste. 202, Charlotte, NC 28204 |
| Street Address |
1459 LAKE BALDWIN LN SUITE A |
| City | ORLANDO |
| State | FL |
| Zip Code | 32814-6741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467435768 | Ali Shaygan | Family Medicine | 1459 Lake Baldwin Ln, Suite A, Orlando, FL 32814-6741 | 2005-11-21 |
| 1306079710 | Derash Inc | Home Health | 1459 Lake Baldwin Ln, Suite A, Orlando, FL 32814-6741 | 2009-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861979353 | Kristen R. Weick | Counselor | 1384 Lake Baldwin Ln, Suite B, Orlando, FL 32814 | 2018-07-26 |
| 1376822056 | Teresa Ann Baker | Audiologist | 1460 Lake Baldwin Ln Apt A, Orlando, FL 32814 | 2011-08-11 |
| 1811120843 | Carolina Teresa Diaz | Counselor | 4225 Fox St. Part 209, Orlando, FL 32814 | 2009-08-25 |
| 1639337231 | Physician Associates LLC | Family Medicine | 855 Outer Road, Physician Associates LLC, Orlando, FL 32814 | 2008-05-30 |
| 1598881369 | Yong Chen | Preventive Medicine | 2433 Lake Baldwin Lane, Orlando, FL 32814 | 2007-03-22 |
| 1285661660 | William Bruna Dunn Iv | Dentist | 950 Lake Baldwin Lane, Orlando, FL 32814 | 2006-06-28 |
| 1295776326 | Wanita Sue Patterson | Nurse Practitioner | 871 Outer Road Unit D, Orlando, FL 32814 | 2006-06-09 |
| 1780663252 | Juan J Herran | Internal Medicine | 1697 Lake Baldwin Ln, Orlando, FL 32814 | 2006-01-12 |
| 1275038085 | Kayla Marie Mannion | Behavior Technician | 907 Outer Rd Ste B, Orlando, FL 32814 | 2018-03-26 |
| 1891295127 | Tiffany Marie Rubio | Midwife | 867 Outer Rd Ste A, Orlando, FL 32814 | 2018-02-13 |
| Find all providers in zip 32814 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467059741 | Aaa Physicians Group | Clinic/Center | 109 Terra Mango Loop Ste B, Orlando, FL 32835-8511 | 2020-10-08 |
| 1598373573 | Lifespan Therapy Services Inc | Clinic/Center | 9472 East Colonial Drive, Orlando, FL 32817 | 2020-07-16 |
| 1043837834 | The Critical Care and Hospital Medicine Group, Pllc | Clinic/Center | 2600 University Acres Dr, Orlando, FL 32817-3024 | 2020-06-29 |
| 1548896822 | Aba Therapy Centers of Excellence Corp | Clinic/Center | 1800 Pembrook Dr Ste 372, Orlando, FL 32810-6928 | 2020-03-18 |
| 1033756374 | Obt Chiropractic Inc | Clinic/Center | 7130 S Orange Blossom Trl, Orlando, FL 32809-5755 | 2019-12-05 |
| 1689210858 | Promed Associates LLC | Clinic/Center | 7642 Blue Quail Ln, Orlando, FL 32835-5815 | 2019-11-22 |
| 1699316760 | Doctors United Group Inc | Clinic/Center | 3300 W Colonial Dr, Orlando, FL 32808-8011 | 2019-09-30 |
| 1649828930 | Orna Aesthetics LLC | Clinic/Center | 6735 Conroy Rd Ste 422, Orlando, FL 32835-3566 | 2019-08-29 |
| 1841842721 | Cigna Onsite Health LLC | Clinic/Center | 2500 W Colonial Dr, Orlando, FL 32804-8005 | 2019-07-11 |
| 1902468077 | Akl Active Inc | Clinic/Center | 1767 Spicebush Ct, Orlando, FL 32828-6847 | 2019-06-28 |
| 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.