Individual provider Active NPI

Robert Wiser, MD

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1790136927
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
139864 Issued in FL
Practice address
86 W Underwood St
Orlando, FL 32806-1110
Phone
(407) 649-6876
Fax
(407) 872-0544
NPI assigned
Jun 29, 2016
Last updated
May 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN23581 FL
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 139864 FL
Pediatrics Physician 208000000X 139864 FL Primary

Addresses

Primary practice location

86 W Underwood St
Orlando, FL 32806-1110

Mailing address

21624 Sullivan Ranch Blvd
Mount Dora, FL 32757-7863
Phone (931) 993-1277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191104001359 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 2365736493 Reassigns benefits to 4 organizations
I20241018001596 AL Practitioner - Emergency Medicine 2365736493 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139864FLMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Emergency Physicians-Heartland LLC CurrentSince Apr 22, 2021 Accepting new patients
Emergency Medicine Services of FL, LLC CurrentSince Sep 24, 2025 Accepting new patients
Emergency Physicians of Central Florida LLP CurrentSince Jul 1, 2022 Accepting new patients
Night Shift Pediatrics LLC Current Accepting new patients
Emergency Physicians Group CurrentSince Jun 11, 2024 Accepting new patients
Orlando Health Medical Group Inc Past Accepting new patients
Orlando Health Medical Group Inc Pediatrics Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

1431 SW 1st Ave
Ocala, FL 34471
Phone (352) 401-1425

1414 S Orange Ave
#112
Orlando, FL 32806
Phone (407) 767-1200

92 W Miller St
Orlando, FL 32806
Phone (321) 841-4607

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1790136927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21624 SULLIVAN RANCH BLVD",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327577863",
            "telephone_number": "931-993-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 W UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "407-649-6876",
            "fax_number": "407-872-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISER",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN23581",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "139864",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "139864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.