Individual provider Active NPI

Wilco Civil, D.O.

  • Internal Medicine Physician
  • Saint Cloud, FL
National Provider Identifier
1679099519
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS16855 Issued in FL
Practice address
2906 17TH St
Saint Cloud, FL 34769-6006
Phone
(321) 841-7856
Fax
(321) 843-6432
NPI assigned
Aug 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X OS16855 FL
Internal Medicine Physician 207R00000X OS16855 FL Primary

Addresses

Primary practice location

2906 17TH St
Saint Cloud, FL 34769-6006

Mailing address

3231 McMullen Booth Rd FL 1
Safety Harbor, FL 34695-6607
Phone (727) 725-6905

Other practice location 1

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone (813) 870-4933

Other identifiers 1

IdentifierTypeStateIssuer
109134800MedicaidFL

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
I20201110000480 FL Practitioner - HospitalistPractitioner - Internal Medicine 4183034713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

2906 17TH St
Saint Cloud, FL 34769-6006
Phone (321) 841-7856

3231 McMullen Booth Rd
Safety Harbor, FL 34695-6607
Phone (727) 725-6526

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2025 Accepting new patients
Baycare Medical Group, Inc. Internal Medicine Current Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
Baycare Medical Group, Inc CurrentSince Jan 12, 2021 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jan 12, 2021 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

601 Main St
Dunedin, FL 34698
Phone (727) 461-1133

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

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

2906 17th St
Saint Cloud, FL 34769
Phone (407) 425-4847

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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.

Hospital & facility affiliations 3

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": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1679099519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 MCMULLEN BOOTH RD FL 1",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346956607",
            "telephone_number": "727-725-6905",
            "fax_number": "727-266-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696006",
            "telephone_number": "321-841-7856",
            "fax_number": "321-843-6432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3231 McMullen Booth Rd",
            "address_purpose": "LOCATION",
            "city": "Safety Harbor",
            "state": "FL",
            "postal_code": "346956607",
            "country_code": "US",
            "telephone_number": "813-870-4933",
            "fax_number": "813-870-4888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIVIL",
        "first_name": "WILCO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-22",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS16855",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS16855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109134800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.