Individual provider Active NPI

Derl Raymond Buzon, APRN

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1013431956
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9192392 Issued in FL
Practice address
258 S Chickasaw TRL Ste 301
Orlando, FL 32825-3501
Phone
(407) 303-7399
Fax
(407) 303-7305
NPI assigned
Aug 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9192392 FL Primary

Addresses

Primary practice location

258 S Chickasaw TRL Ste 301
Orlando, FL 32825-3501

Mailing address

258 S Chickasaw TRL Ste 301
Orlando, FL 32825-3501
Phone (407) 303-7399

Other practice location 1

258 S Chickasaw Trl Ste 201
Orlando, FL 32825-3523
Phone (407) 303-7305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171214002173 FL Practitioner - Nurse Practitioner 7719245042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9192392FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Nov 13, 2017 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 13, 2017 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

258 S Chickasaw Trl
Ste 301
Orlando, FL 32825
Phone (407) 303-7399

258 S Chickasaw Trl
Ste 201
Orlando, FL 32825
Phone (407) 303-6626

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dbuzon73323@adventhealth.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013431956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL STE 301",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253501",
            "telephone_number": "407-303-7399",
            "fax_number": "407-303-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL STE 301",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253501",
            "telephone_number": "407-303-7399",
            "fax_number": "407-303-7305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "258 S Chickasaw Trl Ste 201",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328253523",
            "country_code": "US",
            "telephone_number": "407-303-7305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUZON",
        "first_name": "DERL",
        "middle_name": "RAYMOND",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9192392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.