Individual provider Active NPI

Jorge Ramon Villarreal, M.D.

  • Anesthesiology Physician
  • Winter Haven, FL
National Provider Identifier
1093742413
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME0054730 Issued in FL
Practice address
2400 Dundee Rd
Winter Haven, FL 33884-1166
Phone
(317) 614-9863
Fax
(844) 876-0873
NPI assigned
Jun 28, 2006
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME0054730 FL Primary

Addresses

Primary practice location

2400 Dundee Rd
Winter Haven, FL 33884-1166

Mailing address

PO Box 22201
Tampa, FL 33622-2201
Phone (317) 614-9863

Other identifiers 1

IdentifierTypeStateIssuer
005537900MedicaidFL

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
I20070529000206 FL Practitioner - Anesthesiology 9739198102 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0054730FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management Associates LLC CurrentSince Jul 20, 2006 Accepting new patients
Orlando Anesthesia Consultants PA Anesthesiology CurrentSince Jul 15, 2020 Accepting new patients
Anesthesia Consultants of Central Florida,LLC CurrentSince Mar 8, 2007 Accepting new patients
Capital Anesthesia Solutions of Florida II, LLC Anesthesiology CurrentSince Oct 1, 2020 Accepting new patients
Anesthesia Associates MD PA Anesthesiology Past Accepting new patients
Physicians of Winter Haven LLC PastSince Apr 12, 2006 Accepting new patients

Locations

201 Mohawk Rd
Minneola, FL 34715
Phone (973) 979-9079

8300 Collier Blvd
Naples, FL 34114
Phone (239) 354-6000

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

88 W Kaley St
Orlando, FL 32806
Phone (407) 423-0573

809 E Marion Ave
Punta Gorda, FL 33950
Phone (941) 625-1951

540 The Rialto
Venice, FL 34285
Phone (866) 481-2553

200 Avenue F NE
Winter Haven, FL 33881
Phone (863) 292-4652

2400 Dundee Rd
Winter Haven, FL 33884
Phone (863) 293-8471

Organizations & group practices 6

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1093742413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336222201",
            "telephone_number": "317-614-9863",
            "fax_number": "844-876-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 DUNDEE RD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841166",
            "telephone_number": "317-614-9863",
            "fax_number": "844-876-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "JORGE",
        "middle_name": "RAMON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME0054730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005537900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.