Individual provider Active NPI

Michael Lawrence Banda, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1649997792
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117022 Issued in FL
Practice address
1812 N Mills Ave
Orlando, FL 32803-1854
Phone
(407) 897-3499
Fax
(407) 896-9454
NPI assigned
Oct 19, 2022
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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 NU
Physician Assistant 363A00000X PA9117022 FL Primary

Addresses

Primary practice location

1812 N Mills Ave
Orlando, FL 32803-1854

Mailing address

1812 N Mills Ave
Orlando, FL 32803-1854
Phone (407) 897-3499

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
I20230323001266 FL Practitioner - Physician Assistant 9234503780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
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)

1812 N Mills Ave
Orlando, FL 32803-1834
Phone (407) 897-3499

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

9975 Tavistock Lakes Blvd
Suite 220
Orlando, FL 32827-7665
Phone (407) 930-7801

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Mar 27, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Mar 27, 2023 Accepting new patients

Locations

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

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mbanda480284@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": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1649997792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031854",
            "telephone_number": "407-897-3499",
            "fax_number": "407-896-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031854",
            "telephone_number": "407-897-3499",
            "fax_number": "407-896-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDA",
        "first_name": "MICHAEL",
        "middle_name": "LAWRENCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-19",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.