Active NPI
Reynaldo L Descalso, MD
- Surgery Physician
- Sebring, FL
National Provider Identifier
1700992229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 25032
- Practice address
- 4143 Sun N Lake Blvd
Sebring, FL 33872-2131 - Phone
- (863) 386-6480
- Fax
- (863) 386-6497
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 25032 | FL | Primary |
Addresses
Primary practice location
4143 Sun N Lake Blvd
Sebring, FL 33872-2131
Mailing address
4143 Sun N Lake Blvd
Sebring, FL 33872-2131
Phone (863) 386-6480
Other practice location 1
1221 W Stratford Rd
Avon Park, FL 33825
Phone (863) 453-7579
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037572100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25032 | FL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548115200000",
"number": "1700992229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4143 SUN N LAKE BLVD",
"city": "SEBRING",
"state": "FL",
"postal_code": "338722131",
"telephone_number": "863-386-6480",
"fax_number": "863-386-6497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4143 SUN N LAKE BLVD",
"city": "SEBRING",
"state": "FL",
"postal_code": "338722131",
"telephone_number": "863-386-6480",
"fax_number": "863-386-6497"
}
],
"practiceLocations": [
{
"address_1": "1221 W Stratford Rd",
"address_purpose": "LOCATION",
"city": "Avon Park",
"state": "FL",
"postal_code": "33825",
"country_code": "US",
"telephone_number": "863-453-7579",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DESCALSO",
"first_name": "REYNALDO",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2019-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "25032",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "037572100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sebring, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.