Individual provider Active NPI

Ivette Rosario Robles, M.D.

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1558475194
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME138834 Issued in FL
Practice address
708 E Colonial Dr Ste 200
Orlando, FL 32803-4652
Phone
(407) 895-9255
Fax
(407) 898-9019
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME138834 FL Primary

Addresses

Primary practice location

708 E Colonial Dr Ste 200
Orlando, FL 32803-4652

Mailing address

308 W Bass St
Kissimmee, FL 34741-5001
Phone (407) 483-8801

Other identifiers 6

IdentifierTypeStateIssuer
2126OtherPRPREFERED MEDICARE CHOICE
43080782OtherPRUIA
212266OtherPRPREFERED HEALTH PLAN
660606429OtherPRMMM
6420016OtherPRHUMANA INSURANCE
82259OtherPRTRIPLE S

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110622000329 PR Practitioner - Internal Medicine 3375721392 Practice locations: San Juan, PR
I20190204001577 FL Practitioner - Internal Medicine 3375721392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Healthcare Associates, IncGroup PAC ID 4183606601, 16 clinicians

Practice addresses (Care Compare)

308 W Bass St
Kissimmee, FL 34741-5001
Phone (407) 933-1760

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Healthcare Associates, Inc CurrentSince Jan 22, 2019 Accepting new patients

Locations

308 W Bass St
Kissimmee, FL 34741
Phone (407) 483-8801

708 E Colonial Dr
Ste 200
Orlando, FL 32803
Phone (407) 895-9255

Organizations & group practices 1

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1558475194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 W BASS ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415001",
            "telephone_number": "407-483-8801",
            "fax_number": "407-483-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 E COLONIAL DR STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034652",
            "telephone_number": "407-895-9255",
            "fax_number": "407-898-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO ROBLES",
        "first_name": "IVETTE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME138834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERED MEDICARE CHOICE",
            "identifier": "2126",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UIA",
            "identifier": "43080782",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERED HEALTH PLAN",
            "identifier": "212266",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "660606429",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA INSURANCE",
            "identifier": "6420016",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "82259",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.