Individual provider Active NPI

Brendaliz Asencio, M.D.

  • General Practice Physician
  • Daytona Beach, FL
National Provider Identifier
1780768978
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN430 Issued in FL
Practice address
1640 Technology Blvd Unit 100
Daytona Beach, FL 32117-7315
Phone
(386) 241-1657
Fax
(386) 241-1662
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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 14442 PR
General Practice Physician 208D00000X ACN430 FL Primary

Addresses

Primary practice location

1640 Technology Blvd Unit 100
Daytona Beach, FL 32117-7315

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brendaliz.asencio.1@29601.direct.athenahealth.com

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
I20120821001037 FL Practitioner - General Practice 2860481611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

1640 Technology Blvd
Unit 100
Daytona Beach, FL 32117-7315
Phone (386) 241-1657

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC General Practice CurrentSince Jul 7, 2025 Accepting new patients
Orlando Family Physicians, LLC General Practice PastSince Jan 5, 2025 Accepting new patients
Lina L Feaster PA PastSince Jan 2, 2004 Accepting new patients
Idelis Fedeslinda Arias de la Torre General Practice PastSince Jun 1, 2021 Accepting new patients

Locations

1640 Technology Blvd
Daytona Beach, FL 32117

1640 Technology Blvd
Unit 100
Daytona Beach, FL 32117
Phone (386) 241-1657

5238 Norwood Ave
#16
Jacksonville, FL 32208
Phone (904) 265-2050

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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 2

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1780768978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 TECHNOLOGY BLVD UNIT 100",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177315",
            "telephone_number": "386-241-1657",
            "fax_number": "386-241-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASENCIO",
        "first_name": "BRENDALIZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14442",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brendaliz.asencio.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1640 Technology Blvd Unit 100",
            "city": "Daytona Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321177315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.