ORLANDO IMMUNOLOGY CENTER PA
NPI 1467003772
Internal Medicine - Infectious Disease in Orlando, FL

Q: What is Orlando Immunology Center PA's NPI number?

The NPI number for Orlando Immunology Center PA is 1467003772. It was assigned to this organization in the NPPES registry on September 27, 2019.

Q: What is Orlando Immunology Center PA's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Active since September 27, 2019CLIA 10D0953875 · Waiver

1707 N MILLS AVE, ORLANDO, FL 32803(407) 647-3960(407) 413-5775 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 8, 2024, Nov 20, 2019, Sep 27, 2019 (3 updates tracked since 2019).

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About Orlando Immunology Center Pa NPPES

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

ORLANDO IMMUNOLOGY CENTER PA (NPI 1467003772) is a healthcare organization registered as an infectious disease in Orlando, Florida and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through November 12, 2026 and lists Edwin Dejesus, Owner, as its authorized official.

NPPES Registry Identity

NPI1467003772

Entity TypeOrganization

Primary Taxonomy207RI0200X

Legal Business NameORLANDO IMMUNOLOGY CENTER PA

Location Address1707 N MILLS AVEOrlando, FL 32803-1851

Mailing Address1707 N Mills AveOrlando, FL 32803-1851 · (407) 647-3960 · Fax (407) 413-5775

Phone(407) 647-3960

Fax(407) 413-5775

Organization SubpartNo

Authorized OfficialEdwin DejesusOwner · (407) 647-3960

Enumeration DateSeptember 27, 2019

Last NPPES UpdateMay 8, 20243 updates tracked since enumeration

NPPES CertifiedMay 8, 2024

✔ NPI 1467003772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RI0200X

Definition

An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

1707 N MILLS AVE, Orlando, FL 32803

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Other Identifiers 1

Medicaid104671400FL

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 Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Wellpoint.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 10D0953875

Orlando Immunology Center PA · Orlando, FL

Active · expires Nov 12, 2026

CLIA Number10D0953875

Laboratory TypePhysician Office

Certificate Effective DateNovember 13, 2024

Certificate Expiration DateNovember 12, 2026

Laboratory DirectorEdwin Dejesus

Laboratory Phone(407) 647-3960

Laboratory LocationOrlando Immunology Center PA1707 N Mills Ave, Orlando, FL 32803

CLIA data matches this NPI record on: Address Name Phone

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

Other Providers at the Same Location NPPES 12

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

DR. CHARLOTTE-PAIGE MELANIE ROLLE M.D.

Internal Medicine (Infectious Disease)