Individual provider Active NPI

Daryl Mar, DO

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1255917050
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS20592 Issued in FL
Practice address
2724 N Hiawassee Rd Ste 100
Orlando, FL 32818-3003
Phone
(407) 906-0082
Fax
(407) 604-2606
NPI assigned
Mar 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS20592 FL Primary

Addresses

Primary practice location

2724 N Hiawassee Rd Ste 100
Orlando, FL 32818-3003

Mailing address

2724 N Hiawassee Rd Ste 100
Orlando, FL 32818-3003
Phone (407) 906-0082

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
I20240604002367 FL Practitioner - Family Practice 3779983747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dedicated Senior Medical Center of Florida, LLCGroup PAC ID 4486932100, 56 clinicians

Practice addresses (Care Compare)

2724 N Hiawassee Rd
Suite 200
Orlando, FL 32818-3008
Phone (407) 906-0082

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS20592FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince May 26, 2024 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Jul 1, 2024 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC PastSince May 26, 2024 Accepting new patients

Locations

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

2724 N Hiawassee Rd
Ste 100
Orlando, FL 32818
Phone (407) 906-0082

2724 N Hiawassee Rd
Ste 200
Orlando, FL 32818
Phone (407) 906-0082

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 3

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 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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1255917050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 N HIAWASSEE RD STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183003",
            "telephone_number": "407-906-0082",
            "fax_number": "407-604-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 N HIAWASSEE RD STE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183003",
            "telephone_number": "407-906-0082",
            "fax_number": "407-604-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAR",
        "first_name": "DARYL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS20592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.