Individual provider Active NPI

Denise E Agatep, MD, MS

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Orlando, FL
National Provider Identifier
1609976471
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
ME 90631 Issued in FL
Practice address
4780 N Orange Blossom TRL
Orlando, FL 32810-1601
Phone
(407) 206-3326
Fax
(407) 206-3316
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X ME 90631 FL Primary

Addresses

Primary practice location

4780 N Orange Blossom TRL
Orlando, FL 32810-1601

Mailing address

4780 N Orange Blossom TRL
Orlando, FL 32810-1601
Phone (904) 271-1893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050831000164 FL Practitioner - Preventive Medicine 9931131828 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 90631FLMDPreventive Medicine/Occupational Environmental Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA Current Accepting new patients
American Current Care P.a. CurrentSince Jul 20, 2015 Accepting new patients
American Current Care PA CurrentSince Jul 20, 2015 Accepting new patients
Solantic LLC Past Accepting new patients
Dolores a. Loveless MD, PA Past Accepting new patients

Locations

4933-1 University Blvd W
Jacksonville, FL 32216
Phone (904) 737-7173

1036 Dunn Ave
Ste 10
Jacksonville, FL 32218
Phone (904) 903-5520

1584 Normandy Village Pkwy
Ste 32
Jacksonville, FL 32221
Phone (904) 482-1400

7800 NW 25th St
Ste 4
Miami, FL 33122
Phone (305) 593-2174

4780 N Orange Blossom Trl
Orlando, FL 32810
Phone (407) 206-3326

4455 Medical Center Way
West Palm Beach, FL 33407
Phone (561) 881-0066

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1609976471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4780 N ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328101601",
            "telephone_number": "904-271-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4780 N ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328101601",
            "telephone_number": "407-206-3326",
            "fax_number": "407-206-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGATEP",
        "first_name": "DENISE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "FL",
            "license": "ME 90631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.