Individual provider Active NPI

Raymond Rodriguez Negron, M.D.

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1154874584
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN975 Issued in FL
Practice address
1150 Cypress Glen Cir
Kissimmee, FL 34741-7560
Phone
(407) 483-3200
Fax
(407) 483-3220
NPI assigned
Aug 2, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN975 FL Primary

Addresses

Primary practice location

1150 Cypress Glen Cir
Kissimmee, FL 34741-7560

Mailing address

2201 North Blvd W
Davenport, FL 33837-8990
Phone (863) 419-0688

Other practice location 1

1050 W Carroll St
Kissimmee, FL 34741-1268
Phone (407) 518-0078

Other practice location 2

1804 Oakley Seaver Dr Ste C
Clermont, FL 34711-1925
Phone (352) 242-1021

Other practice location 3

2201 North Blvd W
Davenport, FL 33837-8990
Phone (863) 419-0688

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
I20180116001636 FL Practitioner - General Practice 7517240815 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1150 Cypress Glen Cir
Kissimmee, FL 34741-7560
Phone (407) 483-3200

1804 Oakley Seaver Dr
Suite C
Clermont, FL 34711-1925
Phone (352) 242-1021

2201 N Blvd W
Davenport
Davenport, FL 33837-8990
Phone (863) 419-0688

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Tree Medical Group, PA General Practice CurrentSince Nov 1, 2017 Accepting new patients
Kidsville Pediatrics I, P.a. General Practice CurrentSince Nov 1, 2017 Accepting new patients
Kidsville Pediatrics II, P.a. Past Accepting new patients
PMG Cardiology Inc PastSince Nov 1, 2017 Accepting new patients

Locations

1804 Oakley Seaver Dr
Ste C
Clermont, FL 34711
Phone (352) 242-1021

2201 North Blvd W
Ste 2
Davenport, FL 33837
Phone (863) 353-1246

2201 North Blvd W
Davenport, FL 33837
Phone (863) 353-1246

1050 W Carroll St
Kissimmee, FL 34741
Phone (407) 518-0078

1050 W Carroll St
Ste 2
Kissimmee, FL 34741
Phone (407) 201-3348

1150 Cypress Glen Cir
Kissimmee, FL 34741
Phone (407) 483-3200

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1154874584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 NORTH BLVD W",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378990",
            "telephone_number": "863-419-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 CYPRESS GLEN CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417560",
            "telephone_number": "407-483-3200",
            "fax_number": "407-483-3220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 W Carroll St",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347411268",
            "country_code": "US",
            "telephone_number": "407-518-0078",
            "fax_number": "407-518-0094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1804 Oakley Seaver Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347111925",
            "country_code": "US",
            "telephone_number": "352-242-1021",
            "fax_number": "352-242-1104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 North Blvd W",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338378990",
            "country_code": "US",
            "telephone_number": "863-419-0688",
            "fax_number": "863-419-9547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ NEGRON",
        "first_name": "RAYMOND",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-02",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.