Individual provider Active NPI

Gustavo Vallejo, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Melbourne, FL
National Provider Identifier
1174325559
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME172712 Issued in FL
Practice address
1344 S Apollo Blvd Ste 2a
Melbourne, FL 32901-3183
Phone
(321) 722-9731
Fax
(321) 308-0496
NPI assigned
Mar 26, 2025
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME172712 NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME172712 FL Primary
General Practice Physician 208D00000X ME172712 NU

Addresses

Primary practice location

1344 S Apollo Blvd Ste 2a
Melbourne, FL 32901-3183

Mailing address

1344 S Apollo Blvd Ste 406
Melbourne, FL 32901-3185
Phone (321) 727-2990

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
I20260227002769 FL Practitioner - Endocrinology 4981185832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omni Healthcare, IncGroup PAC ID 5496652380, 42 clinicians

Practice addresses (Care Compare)

1344 S Apollo Blvd
Suite D
Melbourne, FL 32901-3180
Phone (321) 724-1084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME172712FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Healthcare, Inc. Single Specialty CurrentSince Feb 1, 2026 Accepting new patients

Locations

1344 S Apollo Blvd
Ste 406
Melbourne, FL 32901
Phone (321) 253-4032

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.

NPI Registry JSON

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

{
    "created_epoch": "1742947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1174325559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 S APOLLO BLVD STE 406",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013185",
            "telephone_number": "321-727-2990",
            "fax_number": "321-724-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 S APOLLO BLVD STE 2A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013183",
            "telephone_number": "321-722-9731",
            "fax_number": "321-308-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "GUSTAVO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-26",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": "ME172712",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME172712",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": "ME172712",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.