Individual provider Active NPI

Mark Ragoonanan, ARNP

  • Nurse Practitioner
  • Lake Mary, FL
National Provider Identifier
1477119618
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11001275 Issued in FL
Practice address
525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone
(407) 920-3738
NPI assigned
May 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11001275 FL Primary

Addresses

Primary practice location

525 Technology Park Ste 109
Lake Mary, FL 32746-7107

Mailing address

525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone (407) 920-3738

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
I20190702001119 FL Practitioner - Nurse Practitioner 7416281084 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carespot of Orlando Hsi Urgent Care LLCGroup PAC ID 8921372558, 55 clinicians

Practice addresses (Care Compare)

311 S Avalon Park Blvd
Orlando, FL 32828-6781
Phone (407) 295-7557

3840 State Rd
436 Suite 1000
Apopka, FL 32703-6041
Phone (615) 600-4074

5355 Red Bug Lake Rd
Winter Springs, FL 32708-4909
Phone (321) 304-3300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11001275FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Solantic of Jacksonville, LLC CurrentSince Mar 26, 2024 Accepting new patients
Hma/Solantic Joint Venture, LLC CurrentSince Mar 26, 2024 Accepting new patients
Carespot of Orlando Hsi Urgent Care LLC CurrentSince Mar 26, 2024 Accepting new patients
Solantic/South Florida, LLC CurrentSince Mar 26, 2024 Accepting new patients
West Boynton Urgent Care, LLC CurrentSince Mar 26, 2024 Accepting new patients

Locations

3840 State Road 436
Ste 1
Apopka, FL 32703
Phone (407) 478-3202

8756 Boynton Rd W
Ste 150
Boynton Beach, FL 33472
Phone (561) 740-2273

1615 E Highway 50
Ste 200
Clermont, FL 34711
Phone (352) 404-4463

2401 Monument Rd
Jacksonville, FL 32225
Phone (904) 642-0337

18706 NW 67th Ave
Miami Gardens, FL 33015
Phone (786) 563-0280

9035 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 340-5881

1820 58th Ave
Ste 110
Vero Beach, FL 32966
Phone (772) 257-3200

463941 State Road 200
Yulee, FL 32097
Phone (904) 572-1959

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": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1477119618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "407-920-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "407-920-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGOONANAN",
        "first_name": "MARK",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-14",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11001275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.