Individual provider Active NPI

Leyberth Mario Rosendo, MD

  • Family Medicine Physician
  • Altamonte Springs, FL
National Provider Identifier
1891783221
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME72708 Issued in FL
Practice address
661 E Altamonte Dr Ste 324
Altamonte Springs, FL 32701-5103
Phone
(407) 303-3031
Fax
(407) 303-3047
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME72708 FL Primary

Addresses

Primary practice location

661 E Altamonte Dr Ste 324
Altamonte Springs, FL 32701-5103

Mailing address

661 E Altamonte Dr Ste 324
Altamonte Springs, FL 32701-5103
Phone (407) 303-3031

Other identifiers 1

IdentifierTypeStateIssuer
252128800MedicaidFL

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
I20110802000223 FL Practitioner - Family Practice 2062681430 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Feb 1, 2013 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 1, 2013 Accepting new patients

Locations

661 E Altamonte Dr
Ste 324
Altamonte Springs, FL 32701
Phone (407) 303-3031

1475 W Orange Blossom Trl
Apopka, FL 32712
Phone (407) 307-1041

400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

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.

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1891783221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 E ALTAMONTE DR STE 324",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015103",
            "telephone_number": "407-303-3031",
            "fax_number": "407-303-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 E ALTAMONTE DR STE 324",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327015103",
            "telephone_number": "407-303-3031",
            "fax_number": "407-303-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENDO",
        "first_name": "LEYBERTH",
        "middle_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME72708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252128800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.