Individual provider Active NPI

Silvia Maria Cuadra Mongalo, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Port Orange, FL
National Provider Identifier
1912229121
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME125785 Issued in FL
Practice address
740 Dunlawton Ave
Port Orange, FL 32127-4239
Phone
(386) 763-1000
Fax
(386) 481-6399
NPI assigned
Feb 16, 2010
Last updated
Mar 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME125785 FL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME125785 FL Primary

Addresses

Primary practice location

740 Dunlawton Ave
Port Orange, FL 32127-4239

Mailing address

740 Dunlawton Ave
Port Orange, FL 32127-4239
Phone (386) 763-1000

Other practice location 1

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2795
Phone (386) 238-3200

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
I20181024002891 FL Practitioner - Endocrinology 8426301235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

239 N Ridgewood Ave
Edgewater, FL 32132-1734
Phone (386) 427-4868

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME125785FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Sep 10, 2018 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Sep 10, 2018 Accepting new patients

Locations

350 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 238-3200

239 N Ridgewood Ave
Edgewater, FL 32132
Phone (386) 423-4212

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

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, 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": "1266278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1912229121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 DUNLAWTON AVE",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274239",
            "telephone_number": "386-763-1000",
            "fax_number": "386-481-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 DUNLAWTON AVE",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274239",
            "telephone_number": "386-763-1000",
            "fax_number": "386-481-6399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142795",
            "country_code": "US",
            "telephone_number": "386-238-3200",
            "fax_number": "386-481-6399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUADRA MONGALO",
        "first_name": "SILVIA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-16",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME125785",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME125785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

Verify at the official NPI Registry.