Individual provider Active NPI

Luis Alfredo Garcia Fresneda, MD

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1326539388
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1229 Issued in FL
Practice address
1507 N John Young Pkwy
Kissimmee, FL 34741-3214
Phone
(855) 226-6633
NPI assigned
May 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X ACN1229 FL Primary
General Practice Physician 208D00000X 21434 PR

Addresses

Primary practice location

1507 N John Young Pkwy
Kissimmee, FL 34741-3214

Mailing address

601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (727) 322-3439

Other practice location 1

B41 Calle Elliot Velez
Manati, PR 00674
Phone (787) 884-3139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191113000552 PR Practitioner - General Practice 1456681873 Reassigns benefits to 1 organization
I20201112002004 FL Practitioner - General Practice 1456681873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Medical Associates LLCGroup PAC ID 0648271155, 162 clinicians

Practice addresses (Care Compare)

13940 N US Hwy 441
Suite 102
Lady Lake, FL 32159-8909
Phone (352) 751-9900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN1229FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gemipsc CurrentSince Aug 1, 2019 Accepting new patients
Florida Medical Associates LLC CurrentSince Apr 28, 2022 Accepting new patients

Locations

13940 N US Highway 441
Ste 102
Lady Lake, FL 32159
Phone (352) 509-9900

1442 W 1st St
Sanford, FL 32771
Phone (352) 306-0062

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

B41 Calle Elliot Velez
Manati, PR 00674
Phone (787) 621-4364

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: luis.garciafresneda@sl.eclinicaldirectplus.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1326539388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "727-322-3439",
            "fax_number": "800-928-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413214",
            "telephone_number": "855-226-6633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "B41 Calle Elliot Velez",
            "address_purpose": "LOCATION",
            "city": "Manati",
            "state": "PR",
            "postal_code": "00674",
            "country_code": "US",
            "telephone_number": "787-884-3139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA FRESNEDA",
        "first_name": "LUIS",
        "middle_name": "ALFREDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-25",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1229",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21434",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.