MEDICAL VILLAGE HEALTHCARE GROUP (NPI# 1861630626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861630626 |
| Entity Type | Organization |
| Organization Name | MEDICAL VILLAGE HEALTHCARE GROUP |
| Practice Address |
1462 W Oak Ridge Rd Orlando FL 32809-3905 |
| Mailing Address |
816 W Oak St Kissimmee FL 34741-6625 |
| Practice Telephone | 4078886990 |
| Practice Fax Number | 4078883310 |
| Mailing Telephone | 4079449777 |
| Enumeration Date | 2009-01-31 |
| Last Update Date | 2009-02-02 |
| Authorized Official Name | DR. KHALID MANZUR (PRESIDENT) |
| Authorized Official Telephone | 4078886990 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDICAL VILLAGE HEALTHCARE GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | ME81287 | FL | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | ME81287 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | INDIVIDUAL PROVIDER NPI | 1447223193 | 01 |
| FL | INDIVIDUAL PROVIDER NPI | 1376516575 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487621694 | Medical Village Healthcare Group | Internal Medicine | 816 W Oak St, Kissimmee, FL 34741 | 2006-03-07 |
| Street Address |
1462 W OAK RIDGE RD |
| City | ORLANDO |
| State | FL |
| Zip Code | 32809-3905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447223193 | Khalid Manzur | Internal Medicine | 1462 W Oak Ridge Rd, Orlando, FL 32809-3905 | 2006-02-10 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329355 | Brittani Newport | Pediatrics | 10743 Narcoossee Rd Ste A13, Orlando, FL 32832-6946 | 2020-02-24 |
| 1467091959 | Jennifer Dolcater Ketchersid | Pediatrics | 2501 N Orange Ave Ste 586, Orlando, FL 32804-4603 | 2019-12-31 |
| 1396250098 | Advanced Kid's Care | Pediatrics | 98 Terra Mango Loop, Unit 12, Orlando, FL 32835 | 2017-12-05 |
| 1467977454 | Physician Associates LLC | Pediatrics | 14065 Town Loop Blvd Ste 300, Orlando, FL 32837-6199 | 2017-08-10 |
| 1609320837 | Starus Pediatrics LLC | Pediatrics | 6001 Vineland Rd Ste 103, Orlando, FL 32819-7829 | 2016-08-04 |
| 1942656517 | Vijay Mehta | Pediatrics | 60 W Gore St # Mp373, Orlando, FL 32806 | 2016-05-12 |
| 1124401674 | Kelsey Wehrenberg | Pediatrics | 83 Columbia St Ste 202, Orlando, FL 32806 | 2015-07-01 |
| 1396138319 | Premier Physician Associates LLC | Pediatrics | 13651 Hunters Oak Dr, Ste 101, Orlando, FL 32837-7679 | 2015-03-16 |
| 1073917076 | Abdollah Iravani Md Pa | Pediatrics | 2106 N Orange Ave # 100, Orlando, FL 32804-5535 | 2014-10-20 |
| 1720407620 | Christopher Dudek | Pediatrics | 86 W Underwood St Ste 200, Orlando, FL 32806-1110 | 2014-04-08 |
| 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.