Individual provider Active NPI

Ramon F Perez-Mangual

  • Clinical Psychologist
  • Kissimmee, FL
National Provider Identifier
1891030383
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY12159 Issued in FL
Practice address
206 Park Place Blvd
Kissimmee, FL 34741-2344
Phone
(407) 846-0023
Fax
(407) 483-1064
NPI assigned
Dec 10, 2012
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY12159 FL Primary

Addresses

Primary practice location

206 Park Place Blvd
Kissimmee, FL 34741-2344

Mailing address

206 Park Place Blvd
Kissimmee, FL 34741-2344
Phone (407) 846-0023

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240301002324 FL Practitioner - Clinical Psychologist 7416392337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osceola Mental Health IncGroup PAC ID 2062313703, 14 clinicians

Practice addresses (Care Compare)

206 Park Place Blvd
Kissimmee, FL 34741-2344
Phone (407) 846-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Osceola Mental Health Inc CurrentSince Feb 1, 2024 Accepting new patients

Locations

200 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 846-0023

206 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 846-0023

2940 Pleasant Hill Rd
Kissimmee, FL 34746
Phone (407) 846-0023

Organizations & group practices 1

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": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1891030383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 PARK PLACE BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412344",
            "telephone_number": "407-846-0023",
            "fax_number": "407-483-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 PARK PLACE BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412344",
            "telephone_number": "407-846-0023",
            "fax_number": "407-483-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-MANGUAL",
        "first_name": "RAMON",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-10",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY12159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.