NPIMap

Individual provider Active NPI

Alexis Roberto Gonzalez Valles, MD

  • General Practice Physician
  • Saint Cloud, FL
National Provider Identifier
1407409386
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1234 Issued in FL
Practice address
1931 S Narcoossee Rd
Saint Cloud, FL 34771-7211
Phone
(407) 986-9642
Fax
(407) 593-6102
NPI assigned
Jul 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ACN1234 FL
General Practice Physician 208D00000X 21503 PR
General Practice Physician 208D00000X ACN1234 FL Primary

Addresses

Primary practice location

1931 S Narcoossee Rd
Saint Cloud, FL 34771-7211

Mailing address

425 W Colonial Dr Ste 303
Orlando, FL 32804-6863
Phone (321) 332-6947

Other identifiers 2

IdentifierTypeStateIssuer
107646400MedicaidFL
FG8609503OtherFLGENERAL PRACTICE

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
I20191119002129 PR Practitioner - General Practice 9537591151 Practice locations: Juana Diaz, PR
I20200415003652 FL Practitioner - General Practice 9537591151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Sports and Family Health Center PAGroup PAC ID 0840236907, 8 clinicians

Practice addresses (Care Compare)

309 W Bass St
Kissimmee, FL 34741-5011
Phone (407) 935-1192

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 Medicine

State licenses

LicenseStateTypeSpecialty
ACN1234FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Constellation Support Services LLC CurrentSince Mar 20, 2025 Accepting new patients
Orlando Family Physicians, LLC General Practice PastSince Jan 5, 2025 Accepting new patients
Idelis Fedeslinda Arias de la Torre Family Medicine PastSince Jun 1, 2021 Accepting new patients

Locations

5726 Old Cheney Hwy
Orlando, FL 32807
Phone (407) 900-5278

Interoperability endpoints

  • Direct secure messaging: alexis.gonzalez.valles.1@27472.direct.athenahealth.com

Organizations & group practices 4

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": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1407409386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "321-332-6947",
            "fax_number": "407-286-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 S NARCOOSSEE RD",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347717211",
            "telephone_number": "407-986-9642",
            "fax_number": "407-593-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ VALLES",
        "first_name": "ALEXIS",
        "middle_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-19",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ACN1234",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21503",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107646400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL PRACTICE",
            "identifier": "FG8609503",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.