Individual provider Active NPI

Nivia Elis Rodriguez Villanueva, MD

  • General Practice Physician
  • Clermont, FL
National Provider Identifier
1780242586
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1283 Issued in FL
Practice address
2604 S Hwy 27
Clermont, FL 34711-6526
Phone
(844) 665-4827
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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 14993-I PR
General Practice Physician 208D00000X ACN1283 FL Primary

Addresses

Primary practice location

2604 S Hwy 27
Clermont, FL 34711-6526

Mailing address

2604 S Hwy 27
Clermont, FL 34711-6526
Phone (844) 665-4827

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
I20200903003378 FL Practitioner - General Practice 0547687543 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guidewell Sanitas I, LLCGroup PAC ID 9537447107, 124 clinicians

Practice addresses (Care Compare)

3617 W Hillsborough Ave
Tampa, FL 33614-5713
Phone (844) 665-4827

4980 E Irlo Bronson Memorial Hwy
Saint Cloud, FL 34771-8723
Phone (844) 665-4827

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN1283FLMDGeneral Practice Physician
14993-IPRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Family Medical Inc General Practice CurrentSince Aug 1, 2021 Accepting new patients
Guidewell Sanitas I, LLC Current Accepting new patients
Solace Medical Group LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

931 W Oak St
Ste 103
Kissimmee, FL 34741
Phone (407) 922-4839

5425 S Semoran Blvd
Ste 7C
Orlando, FL 32822

1890 Palm Bay Rd NE
Ste 1
Palm Bay, FL 32905
Phone (321) 327-3009

4739 Old Canoe Creek Rd
Saint Cloud, FL 34769
Phone (407) 593-2290

3617 W Hillsborough Ave
Tampa, FL 33614
Phone (813) 675-2020

Interoperability endpoints

  • Direct secure messaging: nivia.rodriguezvillanueva@wwmp.eclinicaldirectplus.com

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": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1780242586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 S HWY 27",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116526",
            "telephone_number": "844-665-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 S HWY 27",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116526",
            "telephone_number": "844-665-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ VILLANUEVA",
        "first_name": "NIVIA",
        "middle_name": "ELIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14993-I",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.