1. Home
  2. Directory
  3. Florida
  4. Kissimmee
  5. General Practice
  6. NPI Profile

EBENEZER MEDICAL CENTER ORLANDO CORP.
NPI 1265178131
General Practice in Kissimmee, FL

Active since May 12, 2022CLIA 10D2275504 · Waiver
845 E OAK STREET, KISSIMMEE, FL 34744(407) 343-1278(888) 498-3604 Get Directions Write a Review

NPPES record last updated: January 24, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 24, 2023, May 12, 2022 (2 updates tracked since 2022).

About Ebenezer Medical Center Orlando Corp. NPPES

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

EBENEZER MEDICAL CENTER ORLANDO CORP. (NPI 1265178131) is a healthcare organization registered as a general practice in Kissimmee, Florida and active in the NPI registry since May 2022. The organization holds a CLIA Waiver certificate valid through January 23, 2027 and lists Maite Jimenez, Owner, as its authorized official.

NPPES Registry Identity

NPI1265178131
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameEBENEZER MEDICAL CENTER ORLANDO CORP.
Location Address845 E OAK STREETKissimmee, FL 34744-5838
Mailing Address845 E Oak StreetKissimmee, FL 34744-5838 · (407) 343-1278 · Fax (888) 498-3604
Phone(407) 343-1278
Fax(888) 498-3604
Organization SubpartNo
Authorized OfficialMaite JimenezOwner · (305) 491-3969
Enumeration DateMay 12, 2022
Last NPPES UpdateJanuary 24, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2023
✔ NPI 1265178131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

845 E OAK STREET, Kissimmee, FL 34744
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 10D2275504

Ebenezer Medical Center Orlando Corp · Kissimmee, FL
Active · expires Jan 23, 2027
CLIA Number10D2275504
Laboratory TypePhysician Office
Certificate Effective DateJanuary 24, 2025
Certificate Expiration DateJanuary 23, 2027
Laboratory DirectorSouheil Moussly
Laboratory Phone(407) 343-1278
Laboratory LocationEbenezer Medical Center Orlando Corp845 E Oak Street, Kissimmee, FL 34744
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebenezer Medical Center Orlando Corp.'s NPI number?

The NPI number for Ebenezer Medical Center Orlando Corp. is 1265178131. It was assigned to this organization in the NPPES registry on May 12, 2022.

Where is Ebenezer Medical Center Orlando Corp. located?

Ebenezer Medical Center Orlando Corp. is located at 845 E Oak Street, Kissimmee, FL 34744. The listed phone number is (407) 343-1278.

What is Ebenezer Medical Center Orlando Corp.'s specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Ebenezer Medical Center Orlando Corp. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2275504) is associated with this NPI, valid through January 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ebenezer Medical Center Orlando Corp. accept?

Health plans from Ambetter Health and Ambetter of Alabama list Ebenezer Medical Center Orlando Corp. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ebenezer Medical Center Orlando Corp. was last updated on January 24, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.