Individual provider Active NPI

Lovell Leonard Mayle, MD

  • Pain Medicine (Anesthesiology) Physician
  • Winter Garden, FL
National Provider Identifier
1073624649
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
ME59012 Issued in FL
Practice address
17000 Porter Rd
Winter Garden, FL 34787-8915
Phone
(321) 842-5052
NPI assigned
Aug 31, 2006
Last updated
Nov 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X ME59012 FL Primary

Addresses

Primary practice location

17000 Porter Rd
Winter Garden, FL 34787-8915

Mailing address

15705 Panther Lake Dr
Winter Garden, FL 34787-4567
Phone (352) 223-0061

Other identifiers 2

IdentifierTypeStateIssuer
271321700MedicaidFL
11640OtherFLBLUE CROSS BLUE SHIELD

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
I20040716000199 FL Practitioner - Anesthesiology 4183603897 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Howard University College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

83 W Miller St
Orlando, FL 32806-2031
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11640FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Apr 11, 2020 Accepting new patients
Anesthesiologists of Greater Orlando Inc CurrentSince Oct 14, 2023 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Jul 1, 2016 Accepting new patients
Anesthesiologists of Greater Orlando Inc Pain Medicine Current Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Apr 11, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Pain Medicine CurrentSince Jul 1, 2016 Accepting new patients
Anesthesiologists of Greater Orlando Inc CurrentSince Oct 14, 2023 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

600 E Dixie Ave
Leesburg, FL 34748
Phone (352) 323-5090

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

10000 W Colonial Dr
Ocoee, FL 34761
Phone (321) 843-1378

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

2906 17th St
Saint Cloud, FL 34769
Phone (407) 425-4847

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

17000 Porter Rd
Winter Garden, FL 34787
Phone (321) 841-3467

Networks

  • Freedom Health HMO Network

Organizations & group practices 7

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1073624649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15705 PANTHER LAKE DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874567",
            "telephone_number": "352-223-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 PORTER RD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347878915",
            "telephone_number": "321-842-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYLE",
        "first_name": "LOVELL",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME59012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271321700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "11640",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

Verify at the official NPI Registry.