Individual provider Active NPI

Maricelis Morales- Colon, MD

  • General Practice Physician
  • Kissimmee, FL
National Provider Identifier
1972538825
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN 434 Issued in FL
Practice address
1962 N John Young Pkwy
Kissimmee, FL 34741-3221
Phone
(866) 218-1211
Fax
(407) 809-5245
NPI assigned
Jul 11, 2006
Last updated
Jun 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 14430 PR
General Practice Physician 208D00000X ACN 434 FL Primary

Addresses

Primary practice location

1962 N John Young Pkwy
Kissimmee, FL 34741-3221

Mailing address

1962 N John Young Pkwy
Kissimmee, FL 34741-3221
Phone (866) 218-1211

Other identifiers 1

IdentifierTypeStateIssuer
005570400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031105000751 PR Practitioner - General Practice 0840102927 Reassigns benefits to 2 organizations
I20120619000152 FL Practitioner - General PracticePractitioner - Internal Medicine 0840102927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

904 W Magnolia St
Kissimmee, FL 34741-4117
Phone (407) 593-2816

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN 434FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Primary Physicians LLC CurrentSince Jun 1, 2022 Accepting new patients
USA Medical Care LLC CurrentSince May 18, 2013 Accepting new patients
Doctors Center Hospital Arecibo Inc CurrentSince Jul 10, 2006 Accepting new patients
CDT Dr Melendez, Inc CurrentSince Nov 9, 2011 Accepting new patients
Central Florida Primary Physicians CurrentSince Jun 1, 2022 Accepting new patients
CDT Dr. Melendez, Inc CurrentSince Nov 9, 2011 Accepting new patients
I Care Clinic LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Town Center Family Medicine LLC PastSince Jul 10, 2012 Accepting new patients

Locations

1565 Saxon Blvd
Ste 103
Deltona, FL 32725
Phone (386) 574-1423

1962 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 935-0623

904 W Magnolia St
Kissimmee, FL 34741
Phone (407) 343-5344

524 13th St
Saint Cloud, FL 34769
Phone (321) 559-7771

Organizations & group practices 9

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1972538825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1962 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413221",
            "telephone_number": "866-218-1211",
            "fax_number": "407-809-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1962 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413221",
            "telephone_number": "866-218-1211",
            "fax_number": "407-809-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES- COLON",
        "first_name": "MARICELIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14430",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN 434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005570400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.