# ADVENTIST HEALTH SYSTEM SUNBELT INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Centre for Family Medicine at Florida Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780777391
- **Authorized official:** DARYL TOL (PRESIDENT/CEO)
- **Authorized official phone:** (407) 303-1531

## Contact information

- **Practice address:** 133 BENMORE DR., SUITE 200, WINTER PARK, FL 32792-4143
- **Practice address phone:** (407) 646-7070
- **Practice address fax:** (407) 646-7747
- **Mailing address:** 133 BENMORE DR., SUITE 200, WINTER PARK, FL 32792-4143
- **Mailing address phone:** (407) 646-7070
- **Mailing address fax:** (407) 646-7747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 05/04/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0022549 | AETNA POS EPO HMO | FL |
| 05 | — | 037458000 | — | FL |
| 01 | — | 4437557 | AETNA PPO | FL |
| 01 | — | 99794 | BLUE CROSS | FL |
| 01 | — | CA 3498 | MEDICARE RAILROAD | FL |
| 01 | — | FHCO | FHHS | FL |