Individual provider Active NPI

Arlene Mary Palazzolo, M.D.

  • Internal Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1295833564
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME36805 Issued in FL
Practice address
2550 Simpson Road
Kissimmee, FL 34744-3806
Phone
(407) 648-0076
Fax
(407) 648-3666
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME36805 FL Primary

Addresses

Primary practice location

2550 Simpson Road
Kissimmee, FL 34744-3806

Mailing address

113 Harrington CT
Davenport, FL 33837-8986
Phone (407) 348-0990

Other practice location 1

1485 Legends Blvd
Champions Gate, FL 33896-8393
Phone (407) 390-6480

Other identifiers 2

IdentifierTypeStateIssuer
002676800MedicaidFL
98292OtherFLPTAN

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
I20100602000625 FL Practitioner - Internal MedicinePractitioner - General Practice 7810026770 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Florida Hospital Medical Group Inc Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Pelican Beach Inc PastSince May 10, 2016 Accepting new patients
Lakeside of Orlando Inc Past Accepting new patients
DMS Medical LLC Past Accepting new patients

Locations

1485 Legends Blvd
Champions Gate, FL 33896
Phone (407) 390-6480

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

4551 Pleasant Hill Rd
Poinciana, FL 34759
Phone (407) 847-2212

Networks

  • 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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1295833564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HARRINGTON CT",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378986",
            "telephone_number": "407-348-0990",
            "fax_number": "407-944-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 SIMPSON ROAD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347443806",
            "telephone_number": "407-648-0076",
            "fax_number": "407-648-3666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1485 Legends Blvd",
            "address_purpose": "LOCATION",
            "city": "Champions Gate",
            "state": "FL",
            "postal_code": "338968393",
            "country_code": "US",
            "telephone_number": "407-390-6480",
            "fax_number": "407-390-6483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALAZZOLO",
        "first_name": "ARLENE",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME36805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002676800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "98292",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.