NPIMap

Individual provider Active NPI

Ruben Edgardo Perez, MD

  • Internal Medicine Physician
  • Winter Haven, FL
National Provider Identifier
1932178308
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME70231 Issued in FL
Practice address
350 1St St N
Winter Haven, FL 33881-4113
Phone
(863) 595-4130
Fax
(863) 595-0459
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME70231 FL Primary

Addresses

Primary practice location

350 1St St N
Winter Haven, FL 33881-4113

Mailing address

350 1St St N
Winter Haven, FL 33881-4113
Phone (863) 595-4130

Other identifiers 2

IdentifierTypeStateIssuer
250120100MedicaidFL
110169445OtherFLMEDICARE ID/ RRM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100318000626 FL Practitioner - Internal Medicine 4789719592 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

350 1St St N
Winter Haven, FL 33881-4113
Phone (863) 595-4130

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME70231FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Florida Hospital Medical Group Inc Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Adventhealth Primary Care Network Inc Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

1485 Legends Blvd
Champions Gate, FL 33896
Phone (407) 390-6480

410 Lionel Way
Ste 320
Davenport, FL 33837
Phone (863) 419-2420

410 Lionel Way
Ste 202
Davenport, FL 33837
Phone (407) 499-0755

1255 State Road 60 E
Ste 500
Lake Wales, FL 33853
Phone (844) 634-3627

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

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

350 1st St N
Winter Haven, FL 33881
Phone (863) 293-8336

Interoperability endpoints

  • Direct secure messaging: rperez58897@adventhealth.direct-ci.com

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1932178308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814113",
            "telephone_number": "863-595-4130",
            "fax_number": "863-595-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814113",
            "telephone_number": "863-595-4130",
            "fax_number": "863-595-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "RUBEN",
        "middle_name": "EDGARDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME70231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250120100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID/ RRM PIN",
            "identifier": "110169445",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.