Individual provider Active NPI

Veronica Gema Pellino, FNP-C

  • Family Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1275412041
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11041931 Issued in FL
Practice address
1667 N Clyde Morris Blvd Ste 2
Daytona Beach, FL 32117-5500
Phone
(386) 518-6401
Fax
(386) 274-2215
NPI assigned
Aug 27, 2025
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11041931 FL Primary

Addresses

Primary practice location

1667 N Clyde Morris Blvd Ste 2
Daytona Beach, FL 32117-5500

Mailing address

1667 N Clyde Morris Blvd # 2
Daytona Beach, FL 32117-5500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251028000818 FL Practitioner - Nurse Practitioner 2163911447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Endocrine Associates IncGroup PAC ID 9133408008, 4 clinicians

Practice addresses (Care Compare)

1667 N Clyde Morris Blvd
Suite 2
Daytona Beach, FL 32117-5500
Phone (386) 274-1414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11041931FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Endocrine Associates, Inc CurrentSince Nov 10, 2025 Accepting new patients
Vera Endocrine Associates Inc CurrentSince Oct 12, 2025 Accepting new patients

Locations

1667 N Clyde Morris Blvd
#2
Daytona Beach, FL 32117
Phone (386) 274-1414

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12862/brand/1/csg/1/fhir/r4
  • Direct secure messaging: veronica.pellino.1@12862.direct.athenahealth.com

Organizations & group practices 2

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 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": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1275412041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1667 N CLYDE MORRIS BLVD # 2",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1667 N CLYDE MORRIS BLVD STE 2",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175500",
            "telephone_number": "386-518-6401",
            "fax_number": "386-274-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLINO",
        "first_name": "VERONICA",
        "middle_name": "GEMA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11041931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.