Individual provider Active NPI

Mauricio Rosero

  • Family Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1710243670
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 122688 Issued in FL
Practice address
3759 Pleasant Hill Rd
Kissimmee, FL 34746-2937
Phone
(863) 419-2723
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME122688 FL
Family Medicine Physician 207Q00000X ME 122688 FL Primary

Addresses

Primary practice location

3759 Pleasant Hill Rd
Kissimmee, FL 34746-2937

Mailing address

3759 Pleasant Hill Rd
Kissimmee, FL 34746-2937

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
I20151016001818 FL Practitioner - Family Practice 1759690522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians Medical Center LLCGroup PAC ID 1355471137, 5 clinicians

Practice addresses (Care Compare)

2445 Sw76Th St
Suite 110
Gainesville, FL 32608-0350
Phone (325) 872-5111

Hospital & facility affiliations

  • Adventhealth Deland Hospital, Deland, FL, CCN 100045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 122688FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Professionals PA CurrentSince Oct 15, 2017 Accepting new patients
Emergency Physicians Medical Center LLC Current Accepting new patients
Emergency Physicians Medical Center, LLC CurrentSince Sep 18, 2025 Accepting new patients

Locations

701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160

9181 NW 39th Ave
Gainesville, FL 32606
Phone (352) 872-5111

2445 SW 76th St
Ste 110
Gainesville, FL 32608
Phone (325) 872-5111

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

Organizations & group practices 3

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1710243670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3759 PLEASANT HILL RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3759 PLEASANT HILL RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462937",
            "telephone_number": "863-419-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSERO",
        "first_name": "MAURICIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME122688",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 122688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.