Individual provider Active NPI

Pablo Doldy Cardona, M.D.

  • Family Medicine Physician
  • Leesburg, FL
National Provider Identifier
1447523493
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME120187 Issued in FL
Practice address
26540 Ace Ave Ste 108C
Leesburg, FL 34748-8279
Phone
(352) 326-5281
Fax
(352) 323-1761
NPI assigned
Feb 21, 2012
Last updated
Aug 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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 ME120187 FL Primary

Addresses

Primary practice location

26540 Ace Ave Ste 108C
Leesburg, FL 34748-8279

Mailing address

1275 NW 122ND St
North Miami, FL 33167-2826
Phone (787) 980-8588

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
I20140923002158 FL Practitioner - Family Practice 9133348147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18550 US Hwy 441
Mount Dora, FL 32757-6751
Phone (352) 735-3755

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
To Your Health of Lake County Inc CurrentSince Aug 12, 2014 Accepting new patients
Physicians of Central Florida PA CurrentSince May 11, 2020 Accepting new patients
Physicians of Central Florida, LLC CurrentSince May 11, 2020 Accepting new patients
Aegis Medical Group LLC PastSince Sep 12, 2022 Accepting new patients

Locations

26540 Ace Ave
Ste 108C
Leesburg, FL 34748
Phone (352) 323-4800

4700 That St
Leesburg, FL 34748
Phone (352) 326-5281

18550 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-3755

10250 SE 167th Place Rd
Unit 5
Summerfield, FL 34491
Phone (352) 307-9225

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDHAD
  • Direct secure messaging: pcardona562462@direct.shands.ufl.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1447523493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 NW 122ND ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331672826",
            "telephone_number": "787-980-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26540 ACE AVE STE 108C",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347488279",
            "telephone_number": "352-326-5281",
            "fax_number": "352-323-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA",
        "first_name": "PABLO",
        "middle_name": "DOLDY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME120187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.