Individual provider Active NPI

Elaine S Condono, D.O.

  • Family Medicine Physician
  • Lakeland, FL
National Provider Identifier
1902913460
Registry record updated Oct 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02095 Issued in WV
Practice address
5538 Vintage View Pass
Lakeland, FL 33812-4061
Phone
(301) 653-9169
NPI assigned
Aug 23, 2006
Last updated
Oct 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X OS11752 FL
Family Medicine Physician 207Q00000X 02095 WV Primary
Family Medicine Physician 207Q00000X OS11752 FL

Addresses

Primary practice location

5538 Vintage View Pass
Lakeland, FL 33812-4061

Mailing address

5538 Vintage View Pass
Lakeland, FL 33812-4061
Phone (301) 653-9169

Other identifiers 1

IdentifierTypeStateIssuer
3810011078MedicaidWV

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
I20120808000437 FL Practitioner - Emergency Medicine 1759380462 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02095WVMDFamily Medicine Physician
2095WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Ies Florida PLLC CurrentSince Dec 1, 2024 Accepting new patients
City Circle ER SVCS Partnership LLC Past Accepting new patients
Carlton ER SVCS Partnership LLC Past Accepting new patients
Town & Country Emergency Physicians LLC Past Accepting new patients
Northern WV Home Health, LLC Past Accepting new patients

Locations

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

502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481

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

8300 Red Bug Lake Rd
Oviedo, FL 32765
Phone (407) 359-6007

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

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

2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122

809 E Marion Ave
Punta Gorda, FL 33950
Phone (941) 625-1951

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

6001 Webb Rd
Twn North Cntry, FL 33615
Phone (813) 579-1402

540 The Rialto
Venice, FL 34285
Phone (866) 481-2553

Organizations & group practices 6

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382659200000",
    "number": "1902913460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5538 VINTAGE VIEW PASS",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124061",
            "telephone_number": "301-653-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5538 VINTAGE VIEW PASS",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124061",
            "telephone_number": "301-653-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDONO",
        "first_name": "ELAINE",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2013-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "FL",
            "license": "OS11752",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "02095",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS11752",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011078",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.