Individual provider Active NPI

Ricardo Villalobos, M.D.

  • Neurology Physician
  • Kissimmee, FL
National Provider Identifier
1073719084
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME124152 Issued in FL
Practice address
2400 N Orange Blossom TR
Ste 204
Kissimmee, FL 34744-2307
Phone
(407) 944-3097
Fax
(407) 944-3098
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 16476 PR
Neurology Physician 2084N0400X ME124152 FL Primary

Addresses

Primary practice location

2400 N Orange Blossom TR
Ste 204
Kissimmee, FL 34744-2307

Mailing address

2400 N Orange Blossom TR
Ste 204
Kissimmee, FL 34744-2307
Phone (407) 944-3097

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
I20151022000506 FL Practitioner - NeurologyPractitioner - Neuropsychiatry 7618043399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Neuropsychiatry
Education
University of Puerto Rico School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13506 Summerport Village Pkwy
Suite 1511
Windermere, FL 34786-7366
Phone (407) 712-5683

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16476PRMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ricardo Villalobos PA Neurology CurrentSince Jan 15, 2019 Accepting new patients
Ponce Neurological Consultants Inc. Neurology PastSince Feb 12, 2011 Accepting new patients

Locations

13506 Summerport Village Pkwy
Windermere, FL 34786
Phone (407) 905-4997

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 and National Provider Directory roles.

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": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1073719084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TR",
            "address_2": "STE 204",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442307",
            "telephone_number": "407-944-3097",
            "fax_number": "407-944-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N ORANGE BLOSSOM TR",
            "address_2": "STE 204",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347442307",
            "telephone_number": "407-944-3097",
            "fax_number": "407-944-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "RICARDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PR",
            "license": "16476",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME124152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.