Individual provider Active NPI

Osvaldo Aviles-Ribot, M.D.

  • General Practice Physician
  • Jacksonville, FL
National Provider Identifier
1811054901
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN539 Issued in FL
Practice address
1918 Blanding Blvd
Jacksonville, FL 32210-3202
Phone
(305) 278-0200
Fax
(305) 851-4110
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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 10493 PR
General Practice Physician 208D00000X ACN539 FL Primary

Addresses

Primary practice location

1918 Blanding Blvd
Jacksonville, FL 32210-3202

Mailing address

6675 Westwood Blvd
Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330

Other identifiers 1

IdentifierTypeStateIssuer
AV82668OtherPRSSS NUMBER, INSURANCE PLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 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
I20140625001896 PR Practitioner - General Practice 2466677992 Practice locations: Canovanas, PR
I20160511001051 FL Practitioner - General Practice 2466677992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Home Alliance, LLCGroup PAC ID 6406096536, 60 clinicians

Practice addresses (Care Compare)

1495 Budinger Ave
Saint Cloud, FL 34769-4157
Phone (407) 593-9890

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Home Alliance, LLC CurrentSince Aug 1, 2021 Accepting new patients
Medical Home Alliance LLC CurrentSince Aug 21, 2019 Accepting new patients
Medical Home Alliance LLC Past Accepting new patients

Locations

6675 Westwood Blvd
Ste 475
Orlando, FL 32821
Phone (407) 845-0384

1495 Budinger Ave
Saint Cloud, FL 34769
Phone (407) 593-9890

199 Avenue K SE
Winter Haven, FL 33880
Phone (563) 588-1424

Networks

  • Freedom Health HMO Network

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1811054901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD",
            "address_2": "STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216027",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322103202",
            "telephone_number": "305-278-0200",
            "fax_number": "305-851-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES-RIBOT",
        "first_name": "OSVALDO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "10493",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS NUMBER, INSURANCE PLA",
            "identifier": "AV82668",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.