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CENTERWELL SENIOR PRIMARY CARE OF SOUTHCHASE
NPI 1598527848
Internal Medicine in Orlando, FL

Active since January 23, 2024CLIA 10D2303791 · Waiver
12402 S ORANGE BLOSSOM TRL STE 6, ORLANDO, FL 32837(407) 541-0114 Get Directions Write a Review

NPPES record last updated: May 10, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Centerwell Senior Primary Care Of Southchase NPPES

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

CENTERWELL SENIOR PRIMARY CARE OF SOUTHCHASE (NPI 1598527848) is a healthcare organization registered as an internal medicine in Orlando, Florida and active in the NPI registry since January 2024. The organization holds a CLIA Waiver certificate valid through April 30, 2028 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1598527848
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE FL INC.
Location Address12402 S ORANGE BLOSSOM TRL STE 6Orlando, FL 32837-6539
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120 · Fax (407) 770-0661
Phone(407) 541-0114
Organization SubpartYes
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateJanuary 23, 2024
Last NPPES UpdateMay 10, 2024
NPPES CertifiedMay 10, 2024
✔ NPI 1598527848 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
12402 S ORANGE BLOSSOM TRL STE 6, Orlando, FL 32837
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Other Names 1

Doing Business AsCenterwell Senior Primary Care Of Southchase

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 10D2303791

Centerwell Senior Primary Care Of Southchase · Orlando, FL
Active · expires Apr 30, 2028
CLIA Number10D2303791
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorJessica Rosario
Laboratory Phone(407) 541-0114
Laboratory LocationCenterwell Senior Primary Care Of Southchase12402 S Orange Blossom Tr Suite 6, Orlando, FL 32837
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

YOEL OLAZABAL PUPO M.D
Family Medicine
12402 S ORANGE BLOSSOM TRL STE 6
ORLANDO, FL 32837
Orange County (407) 541-0114
DR. CAROL MADLYN ESPINAL MD
Family Medicine
12402 S ORANGE BLOSSOM TRL STE 6
ORLANDO, FL 32837
Orange County (407) 541-0114

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 Centerwell Senior Primary Care Fl Inc.'s NPI number?

The NPI number for Centerwell Senior Primary Care Fl Inc. is 1598527848. It was assigned to this organization in the NPPES registry on January 23, 2024. The provider is doing business as Centerwell Senior Primary Care Of Southchase.

Where is Centerwell Senior Primary Care Fl Inc. located?

Centerwell Senior Primary Care Fl Inc. is located at 12402 S Orange Blossom Trl Ste 6, Orlando, FL 32837. The listed phone number is (407) 541-0114.

What is Centerwell Senior Primary Care Fl Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Centerwell Senior Primary Care Fl Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2303791) is associated with this NPI, valid through April 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care Fl Inc. was last updated on May 10, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.