NPIMap

Individual provider Active NPI

Omar V Perez Soto, MD

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1255354841
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN800 Issued in FL
Practice address
2548 Simpson Rd
Kissimmee, FL 34744
Phone
(407) 632-4201
Fax
(407) 632-4206
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X ACN800 FL
General Practice Physician 208D00000X 15643 PR
General Practice Physician 208D00000X ACN800 FL Primary

Addresses

Primary practice location

2548 Simpson Rd
Kissimmee, FL 34744

Mailing address

PO Box 4189
Deerfield Beach, FL 33442-4189
Phone (954) 363-9582

Other identifiers 1

IdentifierTypeStateIssuer
0022909OtherPRPROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041229000580 PR Practitioner - General Practice 1850359456 Reassigns benefits to 1 organization
I20170425003106 FL Practitioner - General Practice 1850359456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valora Medical Center of Florida LLCGroup PAC ID 7113368911, 9 clinicians

Practice addresses (Care Compare)

7151 University Blvd
Unit 100
Winter Park, FL 32792-6724
Phone (321) 275-7500

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Migrant Health Center Western Region,Inc CurrentSince Feb 6, 2009 Accepting new patients
Migrant Health Center Western Region, Inc. CurrentSince Feb 6, 2009 Accepting new patients
Valora Medical Center of Florida LLC CurrentSince Sep 1, 2024 Accepting new patients
Xpress Urgent Care, LLC. General Practice CurrentSince Jun 28, 2022 Accepting new patients
Family Health Group S.S.C.S.P General Practice Past Accepting new patients

Locations

819 N Central Ave
Ste B
Kissimmee, FL 34741
Phone (407) 874-1440

7151 University Blvd
Unit 100
Winter Park, FL 32792
Phone (321) 275-7500

5601 Executive Dr
Ste 200
Irving, TX 75038
Phone (352) 565-7290

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 5

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1255354841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4189",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334424189",
            "telephone_number": "954-363-9582",
            "fax_number": "954-363-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 SIMPSON RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34744",
            "telephone_number": "407-632-4201",
            "fax_number": "407-632-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ SOTO",
        "first_name": "OMAR",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ACN800",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15643",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "0022909",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.