Individual provider Active NPI

Andres Martinez Deleon Jr., ARNP

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1972796878
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP1340632 Issued in FL
Practice address
5979 Vineland Rd Ste 209
Orlando, FL 32819
Phone
(407) 627-0066
Fax
(407) 440-4054
NPI assigned
Aug 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP1340632 FL Primary

Addresses

Primary practice location

5979 Vineland Rd Ste 209
Orlando, FL 32819

Mailing address

121 S Orange Ave Ste 940
Orlando, FL 32801-3234
Phone (407) 658-9687

Other identifiers 1

IdentifierTypeStateIssuer
019974100MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090325000760 FL Practitioner - Nurse Practitioner 1254498819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Sand Lake Internal Medicine, LLC CurrentSince Jun 1, 2021 Accepting new patients
Orlando Family Physicians, LLC PastSince Jan 5, 2025 Accepting new patients

Locations

7300 Sandlake Commons Blvd
Ste 221
Orlando, FL 32819
Phone (407) 284-3552

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1972796878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S ORANGE AVE STE 940",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328013234",
            "telephone_number": "407-658-9687",
            "fax_number": "407-286-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 VINELAND RD STE 209",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32819",
            "telephone_number": "407-627-0066",
            "fax_number": "407-440-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ DELEON",
        "first_name": "ANDRES",
        "name_suffix": "Jr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP1340632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019974100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.