Individual provider Active NPI

Delfin J Fuentes, M.D.

  • Internal Medicine Physician
  • Winter Park, FL
National Provider Identifier
1881727014
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME99867 Issued in FL
Practice address
483 N Semoran Blvd Ste 206
Winter Park, FL 32792-3800
Phone
(407) 678-2400
Fax
(407) 678-4926
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME99867 FL Primary

Addresses

Primary practice location

483 N Semoran Blvd Ste 206
Winter Park, FL 32792-3800

Mailing address

601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (800) 480-5243

Other identifiers 1

IdentifierTypeStateIssuer
279903100MedicaidFL

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
I20071107000768 FL Practitioner - Internal Medicine 7012004088 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Puerto Rico School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care of Central Florida IncGroup PAC ID 8628094018, 39 clinicians

Practice addresses (Care Compare)

12301 Lake Underhill Rd
Suite 215
Orlando, FL 32828-4511
Phone (321) 235-0692

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME99867FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Associates LLC CurrentSince Aug 26, 2024 Accepting new patients

Locations

13940 N US Highway 441
Ste 102
Lady Lake, FL 32159
Phone (352) 509-9900

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

483 N Semoran Blvd
Ste 206
Winter Park, FL 32792
Phone (407) 678-2400

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: delfin.fuentes@sl.eclinicaldirectplus.com

Organizations & group practices 2

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 3

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1881727014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "800-480-5243",
            "fax_number": "800-928-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 N SEMORAN BLVD STE 206",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923800",
            "telephone_number": "407-678-2400",
            "fax_number": "407-678-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "DELFIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME99867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279903100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.