Active NPI
Dibanni Vasquez, M.D.
- Pediatrics Physician
- Lake Park, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME 109534
- Practice address
- 500 US Highway 1
Lake Park, FL 33403-3598 - Phone
- (407) 898-2767
- Fax
- (407) 898-9443
- NPI assigned
- May 2, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pulmonology Physician | 2080P0214X | ME109534 | FL | |
| Pediatrics Physician | 208000000X | ME 109534 | FL | Primary |
Addresses
Primary practice location
500 US Highway 1
Lake Park, FL 33403-3598
Mailing address
2660 W Fairbanks Ave
Winter Park, FL 32789-3385
Phone (407) 898-2767
Other practice location 1
561 NW Lake Whitney Pl Ste 101
Port St Lucie, FL 34986-1624
Phone (407) 898-2767
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119093800 | Medicaid | FL |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 109534 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paragon Emergency Services LLC | Pediatrics | Current | Accepting new patients |
| Hospital Physician Services of Florida PA | Current | Accepting new patients | |
| South Miami Criticare Inc. | Current | Accepting new patients | |
| Emergency Physician Solutions of South Florida, LLC | Past | Accepting new patients | |
| Orlando Pediatric Pulmonary and Sleep Associates PA | Pediatric Pulmonology | Past | Accepting new patients |
Locations
3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404
8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212
9400 W Highway 98
Pensacola, FL 32506
Phone (850) 457-2200
6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611
Interoperability endpoints
- dvasquez493151@direct.memorialcare.org
Organizations & group practices 5
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.
-
- Hospitalist Physician
- Pensacola, FL
- NPI 1558718635
-
- Emergency Medicine Physician
- Winter Haven, FL
- NPI 1912101650
Pediatrics
-
- Emergency Medicine Physician
- South Miami, FL
- NPI 1306878210
-
- Emergency Medicine Physician
- Atlantis, FL
- NPI 1609298181
-
- Pediatric Pulmonology Physician
- Winter Park, FL
- NPI 1316010952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786060800000",
"number": "1124319611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2660 W FAIRBANKS AVE",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327893385",
"telephone_number": "407-898-2767",
"fax_number": "407-898-9443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 US HIGHWAY 1",
"city": "LAKE PARK",
"state": "FL",
"postal_code": "334033598",
"telephone_number": "407-898-2767",
"fax_number": "407-898-9443"
}
],
"practiceLocations": [
{
"address_1": "561 NW Lake Whitney Pl Ste 101",
"address_purpose": "LOCATION",
"city": "Port St Lucie",
"state": "FL",
"postal_code": "349861624",
"country_code": "US",
"telephone_number": "407-898-2767",
"fax_number": "407-898-9443",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VASQUEZ",
"first_name": "DIBANNI",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-02",
"last_updated": "2026-08-07",
"certification_date": "2026-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "FL",
"license": "ME109534",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME 109534",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119093800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lake Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.