Individual provider Active NPI

Yannelly Garrido Antigua, MD

  • General Practice Physician
  • Celebration, FL
National Provider Identifier
1184357378
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1692 Issued in FL
Practice address
2940 Mallory Cir Ste 202
Celebration, FL 34747-1818
Phone
(407) 269-8550
Fax
(407) 288-1010
NPI assigned
Jul 5, 2022
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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 ACN1692 FL Primary

Addresses

Primary practice location

2940 Mallory Cir Ste 202
Celebration, FL 34747-1818

Mailing address

2940 Mallory Cir Ste 202
Celebration, FL 34747-1818
Phone (407) 269-8550

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
I20250404000148 FL Practitioner - General Practice 8426572009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keiler Heberto Moreno Rivero, P.aGroup PAC ID 6002153145, 14 clinicians

Practice addresses (Care Compare)

2940 Mallory Cir
Suite 202
Celebration, FL 34747-1818
Phone (407) 269-8550

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Keiler Heberto Moreno Rivero, P.a. CurrentSince Mar 31, 2025 Accepting new patients

Locations

1065 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 269-8550

2940 Mallory Cir
Ste 202
Kissimmee, FL 34747
Phone (407) 269-8550

2954 Mallory Cir
Ste 200
Kissimmee, FL 34747
Phone (407) 269-8550

13807 Landstar Blvd
Ste 136142
Orlando, FL 32824

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEAGBD

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 1

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1184357378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 MALLORY CIR STE 202",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347471818",
            "telephone_number": "407-269-8550",
            "fax_number": "407-288-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 MALLORY CIR STE 202",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347471818",
            "telephone_number": "407-269-8550",
            "fax_number": "407-288-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRIDO ANTIGUA",
        "first_name": "YANNELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.