Individual provider Active NPI

Mariselys Rosado-Aldarondo, MD

  • Internal Medicine Physician
  • Clermont, FL
National Provider Identifier
1609155183
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME128755 Issued in FL
Practice address
1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone
(352) 536-8840
Fax
(352) 536-8841
NPI assigned
Aug 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28913-R PR
Internal Medicine Physician 207R00000X ME128755 FL Primary

Addresses

Primary practice location

1900 Don Wickham Dr
Clermont, FL 34711-1979

Mailing address

1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 536-8840

Other identifiers 2

IdentifierTypeStateIssuer
18,916OtherPRMEDICAL LICENSE
022847600MedicaidFL

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
I20141210001043 PR Practitioner - Internal Medicine 4486976065 Practice locations: Ponce, PR
I20170327000408 FL Practitioner - Internal Medicine 4486976065 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28913-RPRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Dec 1, 2017 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 1, 2017 Accepting new patients

Locations

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

1900 Don Wickham Dr
Ste 110
Clermont, FL 34711
Phone (352) 241-6460

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mrosadoaldarondo25978@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1609155183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO-ALDARONDO",
        "first_name": "MARISELYS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-15",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "28913-R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME128755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "18,916",
            "state": "PR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022847600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.