Active NPI
Ibelith Miranda-Moreno, MD
- General Practice Physician
- Kissimmee, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- ACN1390
- Practice address
- 1051 Kevstin Dr
Kissimmee, FL 34744-5811 - Phone
- (321) 257-8007
- Fax
- (407) 490-1309
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | ACN1390 | FL | Primary |
Addresses
Primary practice location
1051 Kevstin Dr
Kissimmee, FL 34744-5811
Mailing address
PO Box 4189
Deerfield Beach, FL 33442-4189
Phone (954) 363-9582
Other practice location 1
2548 Simpson Rd
Kissimmee, FL 34744-4637
Phone (407) 632-4201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112495900 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7151 University Blvd
Unit 100
Winter Park, FL 32792-6724
Phone (321) 275-7500
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACN1390 | FL | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valora Medical Center of Florida LLC | Clinic/Center | Current | Accepting new patients |
| Patient Medical Center of Florida Inc | General Practice | Current | Accepting new patients |
| Orlando Family Physicians, LLC | General Practice | Past | Accepting new patients |
| Family Health Group S.S.C.S.P | General Practice | Past | Accepting new patients |
| Lina L Feaster PA | Clinic/Center | Past | Accepting new patients |
| Programa Medico del Norte, Inc. | Clinic/Center | Past | Accepting new patients |
Locations
819 N Central Ave
Ste A
Kissimmee, FL 34741
Phone (407) 288-8242
819 N Central Ave
Kissimmee, FL 34741
Phone (407) 288-8242
7151 University Blvd
Unit 100
Winter Park, FL 32792
Phone (321) 275-7500
5601 Executive Dr
Ste 200
Irving, TX 75038
Phone (352) 565-7290
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Kissimmee, FL
- NPI 1316705650
Clinic/Center
-
- Family Medicine Physician
- Kissimmee, FL
- NPI 1891206504
General Practice
-
- Primary Care Clinic/Center
- St Augustine, FL
- NPI 1922205251
-
- General Practice Physician
- Orlando, FL
- NPI 1912579673
-
- General Practice Physician
- San Sebastian, PR
- NPI 1700962586
-
- Emergency Care Clinic/Center
- Hatillo, PR
- NPI 1538266952
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753315200000",
"number": "1477575207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4189",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334424189",
"telephone_number": "954-363-9582",
"fax_number": "954-363-9663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051 KEVSTIN DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347445811",
"telephone_number": "321-257-8007",
"fax_number": "407-490-1309"
}
],
"practiceLocations": [
{
"address_1": "2548 Simpson Rd",
"address_purpose": "LOCATION",
"city": "Kissimmee",
"state": "FL",
"postal_code": "347444637",
"country_code": "US",
"telephone_number": "407-632-4201",
"fax_number": "407-632-4206",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRANDA-MORENO",
"first_name": "IBELITH",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2025-07-24",
"certification_date": "2025-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ACN1390",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112495900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.