Jorge L. Vazquez, MD – General Practice Physician

Key facts

NPI: 1992990212
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Physician 208D00000X
License: ME107365 (FL)
Practice address: 1140 S Semoran Blvd
Suite E
Orlando, FL 32807-1459
Phone: (407) 384-9165
Fax: (407) 384-9174
NPI assigned: Sep 10, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

PCC Medical Holdings LLC Internal Medicine Physician · Lake Worth, FL · NPI 1174167993

Medicare reassignment Care Compare group NPD FL

Hospital & facility affiliations 3

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

Adventist Health System-Sunbelt, Inc General Acute Care Hospital · Orlando, FL · NPI 1306938071

Care Compare affiliation Hospital
Adventist Health System-Sunbelt, Inc Clinical Medical Laboratory · Orlando, FL · NPI 1801569728

Care Compare affiliation Hospital
American Dream Home Health Care, Corp. Home Health Agency · Orlando, FL · NPI 1578242665

Care Compare affiliation Home health agency

Medicare Care Compare profile

Specialty: Pediatric Medicine
Also: General Practice
Education: Other, 1990
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: PCC Medical Holdings LLC (27 clinicians)

Practice addresses (Care Compare)

1140 S Semoran Blvd E
PCC of Semoran
Orlando, FL 32807-1459
Phone (407) 384-9165

Hospital & facility affiliations

American Dream Home Health Care, Corp Home health agency · Orlando, FL · CCN 687357
Adventhealth Orlando Hospital · Orlando, FL · CCN 100007

Medicare participation

Medicare fee-for-service enrollment: Enrolled in FL
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20110808000283	FL	Practitioner - Pediatric Medicine Practitioner - General Practice	4486823523	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles (1 of 3)

Organization	Specialty	Status	New patients
PCC Medical Holdings LLC		Current since Jul 20, 2020	Accepting new patients

Locations

1140 S Semoran Blvd
Ste E
Orlando, FL 32807
Phone (407) 384-9165

Networks

Freedom Health HMO Network
Optimum HealthCare HMO Network

Interoperability endpoints

Direct secure messaging: jorge.vazquez.1@32578.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Physician	208D00000X	ME107365	FL	Yes

Addresses

Primary practice location

1140 S Semoran Blvd
Suite E
Orlando, FL 32807-1459

Mailing address

1140 S Semoran Blvd
Suite E
Orlando, FL 32807-1459
Phone (407) 384-9165

Other identifiers

Identifier	Type	State	Issuer
003738500	Medicaid	FL

Other providers in Orlando, FL

All providers in Orlando, FL · General Practice Physician in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.