CENTER FOR DIGESTIVE ENDOSCOPY
NPI 1063479459
Clinic/Center in Orlando, FL

Q: What is Center For Digestive Endoscopy's NPI number?

The NPI number for Center For Digestive Endoscopy is 1063479459. It was assigned to this organization in the NPPES registry on April 28, 2006.

Q: What is Center For Digestive Endoscopy's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since April 28, 2006CLIA Certified · 2 labs

1817 N MILLS AVE, ORLANDO, FL 32803(407) 896-1726(407) 896-9716 Get Directions Write a Review

NPPES record last updated: September 20, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Center For Digestive Endoscopy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTER FOR DIGESTIVE ENDOSCOPY (NPI 1063479459) is a healthcare organization registered as a clinic/center in Orlando, Florida and active in the NPI registry since April 2006. The organization holds 2 active CLIA laboratory certificates and lists William Brandon Ruderman, President, as its authorized official.

NPPES Registry Identity

NPI1063479459

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameCENTER FOR DIGESTIVE ENDOSCOPY

Location Address1817 N MILLS AVEOrlando, FL 32803

Mailing Address1817 N Mills AveOrlando, FL 32803 · (407) 896-1726 · Fax (407) 896-9716

Phone(407) 896-1726

Fax(407) 896-9716

Organization SubpartNo

Authorized OfficialWilliam Brandon RudermanPresident · (407) 896-1726

Enumeration DateApril 28, 2006

Last NPPES UpdateSeptember 20, 2007

✔ NPI 1063479459 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

License✔ Licensed in FL · 1139

Definition

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).

1817 N MILLS AVE, Orlando, FL 32803

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Other Identifiers 1

Medicare ID-Type UnspecifiedF1367FL

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0996127

Center For Digestive Endoscopy · Orlando, FL

Active · expires Feb 10, 2028

CLIA Number10D0996127

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateFebruary 11, 2026

Certificate Expiration DateFebruary 10, 2028

Laboratory DirectorHenry Levine MD

Laboratory Phone(407) 241-3221

Laboratory LocationCenter For Digestive Endoscopy1817 North Mills Ave, Orlando, FL 32803

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D1021196

Center For Digestive Health · Orlando, FL

Active · expires Jan 14, 2028

CLIA Number10D1021196

Laboratory TypePhysician Office

Certificate Effective DateJanuary 15, 2026

Certificate Expiration DateJanuary 14, 2028

Laboratory DirectorHenry Levine

Laboratory Phone(407) 896-1726

Laboratory LocationCenter For Digestive Health1817 N Mills Ave, Orlando, FL 32803

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS JACQUELINE BONNY LARREA A.R.N.P.

Nurse Practitioner (Family)