Individual provider Active NPI

Cathy Y Roman Ramos

  • Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1710688528
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11024897 Issued in FL
Practice address
715 E Vine St
Kissimmee, FL 34744-4232
Phone
(407) 930-1112
NPI assigned
Mar 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11024897 FL Primary

Addresses

Primary practice location

715 E Vine St
Kissimmee, FL 34744-4232

Mailing address

PO Box 570038
Orlando, FL 32857-0038

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
I20230417000639 FL Practitioner - Nurse Practitioner 1456726876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advantage Medical Group LLCGroup PAC ID 1153614623, 8 clinicians

Practice addresses (Care Compare)

1117 S Semoran Blvd
Orlando, FL 32807-1480
Phone (407) 930-1112

2407 US Hwy 98 N
Lakeland, FL 33805-2410
Phone (407) 930-1112

2415 Enterprise Rd
Orange City, FL 32763-7964
Phone (407) 930-1112

715 E Vine St
Suite 1
Kissimmee, FL 34744-4232
Phone (407) 930-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11024897FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Medical Group LLC Nurse Practitioner CurrentSince Mar 20, 2023 Accepting new patients
Advantage Medical Group LLC Past Accepting new patients
Life Rehab and Wellness Center LLC PastSince Mar 19, 2023 Accepting new patients

Locations

715 E Vine St
Kissimmee, FL 34744
Phone (407) 930-1112

2407 US Highway 98 N
Lakeland, FL 33805
Phone (407) 930-1112

1111 S Semoran Blvd
Ste B
Orlando, FL 32807
Phone (407) 930-1112

1117 S Semoran Blvd
Orlando, FL 32807
Phone (407) 930-1112

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1710688528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570038",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328570038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E VINE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444232",
            "telephone_number": "407-930-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN RAMOS",
        "first_name": "CATHY",
        "middle_name": "Y",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11024897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.