Individual provider Active NPI

Eduardo Luis Nogales

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1669092912
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
161769 Issued in FL
Practice address
52 W Underwood St
Orlando, FL 32806-1110
Phone
(321) 843-2584
NPI assigned
Apr 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 161769 FL Primary

Addresses

Primary practice location

52 W Underwood St
Orlando, FL 32806-1110

Mailing address

317 W Jean St
Tampa, FL 33604
Phone (787) 383-0567

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
I20230714002262 FL Practitioner - Internal Medicine 6800213406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Specialists GroupGroup PAC ID 0345584835, 66 clinicians

Practice addresses (Care Compare)

203 N Marion St
FL 2
Tampa, FL 33602-4914
Phone (813) 428-6904

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
161769FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists Group Internal Medicine CurrentSince Jul 5, 2023 Accepting new patients
Inpatient Specialists Group Internal Medicine CurrentSince Jul 5, 2023 Accepting new patients

Locations

203 N Marion St
Ste 3
Tampa, FL 33602

203 N Marion St
Tampa, FL 33602
Phone (813) 474-9804

203 N Marion St
Fl 2
Tampa, FL 33602
Phone (813) 428-6904

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1669092912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W JEAN ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33604",
            "telephone_number": "787-383-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 W UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "321-843-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOGALES",
        "first_name": "EDUARDO",
        "middle_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "161769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.