Individual provider Active NPI

Jose A Flores Guevara, M.D.

  • Ophthalmology Physician
  • Saint Cloud, FL
National Provider Identifier
1922006337
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME135894 Issued in FL
Practice address
4589 Henry C. Yates Lane
Saint Cloud, FL 34769
Phone
(407) 891-2010
Fax
(407) 891-8211
NPI assigned
Jul 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 11435 PR
Ophthalmology Physician 207W00000X ME135894 FL Primary

Addresses

Primary practice location

4589 Henry C. Yates Lane
Saint Cloud, FL 34769

Mailing address

4589 Henry C. Yates LN
Saint Cloud, FL 34769
Phone (407) 891-2010

Other practice location 1

1121 Miranda Lane
Kissimmee, FL 34741
Phone (407) 530-5977

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
I20181005002565 FL Practitioner - Ophthalmology 0446296198 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME135894FLMDOphthalmology Physician
11435PRMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Cloud Eye Center Inc Ophthalmology CurrentSince Jun 26, 2018 Accepting new patients
St Cloud Eye Center Inc Ophthalmology CurrentSince Jun 26, 2018 Accepting new patients
Crystal River Eye Center,LLC Ophthalmology CurrentSince May 16, 2021 Accepting new patients
St. Cloud Eye Center, Inc Ophthalmology Past Accepting new patients

Locations

295 SE US Highway 19
Crystal River, FL 34429
Phone (352) 795-6622

1121 Miranda Ln
Kissimmee, FL 34741
Phone (407) 425-7188

60 SW 17th St
Ocala, FL 34471
Phone (352) 482-0305

4691 Old Canoe Creek Rd
Saint Cloud, FL 34769
Phone (407) 271-3430

1330 Budinger Ave
Ste 200
Saint Cloud, FL 34769

4589 H C Yates Ln
Saint Cloud, FL 34769
Phone (407) 329-7701

Organizations & group practices 4

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": "1120867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1922006337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4589 HENRY C. YATES LN",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "34769",
            "telephone_number": "407-891-2010",
            "fax_number": "407-891-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4589 HENRY C. YATES LANE",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "34769",
            "telephone_number": "407-891-2010",
            "fax_number": "407-891-8211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 Miranda Lane",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "34741",
            "country_code": "US",
            "telephone_number": "407-530-5977",
            "fax_number": "407-891-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORES GUEVARA",
        "first_name": "JOSE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-09",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PR",
            "license": "11435",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME135894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

Verify at the official NPI Registry.