Individual provider Active NPI

Carlos Felico Pupo Sr., APRN

  • General Practice Registered Nurse
  • Kissimmee, FL
National Provider Identifier
1073113973
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
11009813 Issued in FL
Practice address
2900 Loopdale LN
Kissimmee, FL 34741-7658
Phone
(407) 900-0232
Fax
(407) 675-3558
NPI assigned
Oct 29, 2020
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 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 Registered Nurse 163WG0000X 11009813 FL Primary

Addresses

Primary practice location

2900 Loopdale LN
Kissimmee, FL 34741-7658

Mailing address

2900 Loopdale LN
Kissimmee, FL 34741-7658
Phone (407) 900-0232

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
I20210923003606 FL Practitioner - Nurse Practitioner 8325445901 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11009813FLMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
RPS Primary Medical Center PLLC CurrentSince Jan 3, 2026 Accepting new patients
RPS Primary Medical Center PLLC CurrentSince Nov 8, 2025 Accepting new patients

Locations

2900 Loopdale Ln
Kissimmee, FL 34741
Phone (407) 900-0232

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDGECD
  • FHIR API: https://fhir4.healow.com/fhir/r4/IDGECD/Endpoint/IDGECD

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.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1073113973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LOOPDALE LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417658",
            "telephone_number": "407-900-0232",
            "fax_number": "407-675-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LOOPDALE LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417658",
            "telephone_number": "407-900-0232",
            "fax_number": "407-675-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICO PUPO",
        "first_name": "CARLOS",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-29",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "11009813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.