Individual provider Active NPI

Wandaly Ibon Pardo-Ruiz, M.D.

  • Hematology & Oncology Physician
  • Oviedo, FL
National Provider Identifier
1154525566
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
18,117 Issued in PR
Practice address
658 Oviedo Medical Dr
Oviedo, FL 32765-6574
Phone
(407) 901-9076
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 18,117 PR Primary

Addresses

Primary practice location

658 Oviedo Medical Dr
Oviedo, FL 32765-6574

Mailing address

1191 Pallister LN
Lake Mary, FL 32746-1950
Phone (787) 225-7213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111018000207 PR Practitioner - Hematology/OncologyPractitioner - Internal Medicine 6406028406 Reassigns benefits to 1 organization
Practice locations: Hato Rey, PR
I20190306001647 FL Practitioner - Hematology/Oncology 6406028406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Puerto Rico School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Florida Cancer Centers LLCGroup PAC ID 4880584135, 13 clinicians

Practice addresses (Care Compare)

2776 Enterprise Rd
Suite 100
Orange City, FL 32763-8316
Phone (386) 774-1223

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
91.45
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18,117PRMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Florida Cancer Centers LLC Hematology & Oncology CurrentSince Apr 1, 2019 Accepting new patients
Hospital Espanol Auxilio Mutuo de Puerto Rico, Inc. Current Accepting new patients

Locations

2776 Enterprise Rd
#100
Orange City, FL 32763
Phone (386) 774-1223

658 Oviedo Medical Dr
Oviedo, FL 32765
Phone (407) 265-2540

2100 W 1st St
Sanford, FL 32771
Phone (407) 323-2250

715 Ave Ponce de Leon
Stop 375
San Juan, PR 00917
Phone 7877582000 ext. 3216

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1154525566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 PALLISTER LN",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461950",
            "telephone_number": "787-225-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 OVIEDO MEDICAL DR",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656574",
            "telephone_number": "407-901-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDO-RUIZ",
        "first_name": "WANDALY",
        "middle_name": "IBON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PR",
            "license": "18,117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.