Individual provider Active NPI

Osmany Lazaro Rodriguez Herrada, MD

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1063131605
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1576 Issued in FL
Practice address
2548 Simpson Rd
Kissimmee, FL 34744-4637
Phone
(407) 632-4201
Fax
(407) 632-4206
NPI assigned
Aug 25, 2022
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN1576 FL Primary

Addresses

Primary practice location

2548 Simpson Rd
Kissimmee, FL 34744-4637

Mailing address

PO Box 4189
Deerfield Beach, FL 33442-4189
Phone (954) 363-9582

Other practice location 1

819 N Central Ave Ste A
Kissimmee, FL 34741-5027
Phone (407) 288-8242

Other identifiers 1

IdentifierTypeStateIssuer
120589900MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231103002669 FL Practitioner - General Practice 2264889823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Consultants of Florida LLCGroup PAC ID 6002988847, 35 clinicians

Practice addresses (Care Compare)

2548 Simpson Rd
Kissimmee, FL 34744-4637
Phone (407) 632-4201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Consultants of Florida, LLC Multi-Specialty CurrentSince Apr 1, 2025 Accepting new patients
Patient Medical Center of Florida Inc Multi-Specialty CurrentSince Apr 1, 2025 Accepting new patients
Idelis Fedeslinda Arias de la Torre Multi-Specialty PastSince Oct 1, 2023 Accepting new patients
Orlando Family Physicians, LLC Multi-Specialty PastSince Jan 5, 2025 Accepting new patients

Locations

2548 Simpson Rd
Kissimmee, FL 34744
Phone (407) 632-4201

819 N Central Ave
Kissimmee, FL 34741
Phone (407) 288-8242

819 N Central Ave
Ste A
Kissimmee, FL 34741
Phone (407) 288-8242

672 SW Prima Vista Blvd
Ste 101
Port St Lucie, FL 34983
Phone (772) 905-2555

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1063131605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4189",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334424189",
            "telephone_number": "954-363-9582",
            "fax_number": "954-363-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 SIMPSON RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444637",
            "telephone_number": "407-632-4201",
            "fax_number": "407-632-4206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 N Central Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347415027",
            "country_code": "US",
            "telephone_number": "407-288-8242",
            "fax_number": "407-490-1309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ HERRADA",
        "first_name": "OSMANY",
        "middle_name": "LAZARO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-25",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120589900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.