Individual provider Active NPI

Daniela Herrera Ceballos, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Celebration, FL
National Provider Identifier
1497375075
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9114785 Issued in FL
Practice address
410 Celebration PL Ste 402
Celebration, FL 34747-5436
Phone
(407) 303-4080
NPI assigned
Apr 23, 2020
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7885 MA
Physician Assistant 363A00000X 9114785 FL Primary

Addresses

Primary practice location

410 Celebration PL Ste 402
Celebration, FL 34747-5436

Mailing address

410 Celebration PL Ste 402
Celebration, FL 34747-5436
Phone (407) 303-4080

Other practice location 1

55 Fruit St.
BLK 1500
Boston, MA 02114
Phone (617) 643-0604

Other practice location 2

7867 N Kendall Dr Ste 135
Miami, FL 33156-7736
Phone (305) 598-1555

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
I20220126000187 FL Practitioner - Physician Assistant 7214343219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2400 N Orange Blossom TRL
Kissimmee, FL 34744-2308

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7885MAMDMental Health Counselor
9114785FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Jan 29, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 29, 2024 Accepting new patients

Locations

2400 N Orange Blossom Trl
Ste 302
Kissimmee, FL 34744
Phone (407) 932-6193

2488 E Irlo Bronson Memorial Hwy
Ste 202
Kissimmee, FL 34744

410 Celebration Pl
Ste 402
Kissimmee, FL 34747
Phone (407) 296-1871

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: dherreraceballos2218020@adventhealth.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1497375075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 402",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "407-303-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 402",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "407-303-4080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St.",
            "address_2": "BLK 1500",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02114",
            "country_code": "US",
            "telephone_number": "617-643-0604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7867 N Kendall Dr Ste 135",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331567736",
            "country_code": "US",
            "telephone_number": "305-598-1555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRERA CEBALLOS",
        "first_name": "DANIELA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "7885",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9114785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.