Individual provider Active NPI

Jose Gregorio Polo-Cueto, M.D ACN

  • General Practice Physician
  • Orlando, FL
National Provider Identifier
1609127307
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN496 Issued in FL
Practice address
832 W Central Blvd
Orlando, FL 32805-1809
Phone
(407) 723-4244
Fax
(407) 845-6119
NPI assigned
Sep 21, 2012
Last updated
Aug 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN496 FL Primary
General Practice Physician 208D00000X 20004 PR

Addresses

Primary practice location

832 W Central Blvd
Orlando, FL 32805-1809

Mailing address

832 W Central Blvd
Orlando, FL 32805-1809
Phone (407) 723-4244

Other identifiers 1

IdentifierTypeStateIssuer
P208-844-85-500-0OtherFLDRIVER LICENSE

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
I20160616000349 FL Practitioner - Family Practice 7911224431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Department of HealthGroup PAC ID 3072424282, 126 clinicians

Practice addresses (Care Compare)

249 E Collins St
Umatilla, FL 32784-8383
Phone (352) 483-7977

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN 946FLMDGeneral Practice Physician
20004PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Dec 15, 2024 Accepting new patients
Florida Department of Health CurrentSince Apr 19, 2023 Accepting new patients
Florida Department of Health CurrentSince Apr 19, 2023 Accepting new patients
Florida Department of Health Past Accepting new patients
DMS Medical LLC PastSince May 10, 2016 Accepting new patients

Locations

2113 Griffin Rd
Leesburg, FL 34748
Phone (352) 483-7977

6101 Lk Ellenor Dr
Orlando, FL 32809
Phone (407) 723-5029

832 W Central Blvd
Orlando, FL 32805
Phone (407) 836-2619

249 E Collins St
Umatilla, FL 32784
Phone (352) 483-7977

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1609127307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 W CENTRAL BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051809",
            "telephone_number": "407-723-4244",
            "fax_number": "407-845-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 W CENTRAL BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051809",
            "telephone_number": "407-723-4244",
            "fax_number": "407-845-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLO-CUETO",
        "first_name": "JOSE",
        "middle_name": "GREGORIO",
        "name_prefix": "Dr.",
        "credential": "M.D ACN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-21",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN496",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "20004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "P208-844-85-500-0",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.