Individual provider Active NPI

Ceferina Bondoc Del Rosario, MD

  • Internal Medicine Physician
  • Davenport, FL
National Provider Identifier
1124039789
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 74133 Issued in FL
Practice address
103 N Escambia Avenue
Davenport, FL 33837-4119
Phone
(863) 421-7778
Fax
(863) 421-7795
NPI assigned
Aug 10, 2006
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 74133 FL Primary

Addresses

Primary practice location

103 N Escambia Avenue
Davenport, FL 33837-4119

Mailing address

103 N Escambia Ave
Davenport, FL 33837-4119
Phone (863) 421-7778

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
I20080506000126 FL Practitioner - Internal Medicine 7719066521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

103 Escambia Ave
Davenport, FL 33837-4119
Phone (863) 421-7778

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 74133FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Services of Polk County Inc Internal Medicine CurrentSince Jan 15, 2007 Accepting new patients

Locations

103 Escambia Ave
Davenport, FL 33837
Phone (863) 421-7778

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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 7

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1124039789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N ESCAMBIA AVE",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338374119",
            "telephone_number": "863-421-7778",
            "fax_number": "863-421-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N ESCAMBIA AVENUE",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338374119",
            "telephone_number": "863-421-7778",
            "fax_number": "863-421-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL ROSARIO",
        "first_name": "CEFERINA",
        "middle_name": "BONDOC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 74133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.