AdventHealth Senior Care – Internal Medicine Physician, NPI 1336756204
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for AdventHealth Senior Care
2954 Mallory Cir Ste 200
Kissimmee, FL 347471822
Phone: (407) 238-0137
Fax: (407) 238-0138
Type: Location
12880 US Highway 301
Dade City, FL 335255801
Phone: (813) 492-5732
Type: Location
1595 N Williamson Blvd
Daytona Beach, FL 321177214
Phone: (386) 259-6026
Type: Location
303 E Altamonte Dr Ste 1000
Altamonte Springs, FL 327014403
Phone: (407) 349-7917
Type: Location
305 CLYDE MORRIS BLVD STE 130
ORMOND BEACH, FL 321748182
Phone: (386) 231-6280
Type: Location
2690 S Orlando Dr
Sanford, FL 327735339
Phone: (407) 200-0547
Type: Location
2906 David Walker Dr
Eustis, FL 327266177
Phone: (352) 363-5921
Type: Location
400 CLYDE MORRIS BLVD STE A
ORMOND BEACH, FL 321748172
Phone: (386) 615-6664
Fax: (386) 615-6665
Type: Location
900 HOPE WAY
ALTAMONTE SPRINGS, FL 327141502
Phone:
Type: Mailing
1030 W CANTON AVE STE G100
WINTER PARK, FL 327893050
Phone: (407) 901-4086
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-10-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-07-31 (52 days away).
Enrollment records
1
Earliest due date
2026-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20201009001594 | O | Clinic/Group Practice | FL | 2026-07-31 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 34747)
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