Individual provider Active NPI

Ana Julia Fandino, MD

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1033157938
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 91994 Issued in FL
Practice address
10300 SW 72ND St Ste 430
Miami, FL 33173-3021
Phone
(786) 427-6644
Fax
(786) 623-0931
NPI assigned
Jun 3, 2006
Last updated
Dec 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME 91994 FL Primary

Addresses

Primary practice location

10300 SW 72ND St Ste 430
Miami, FL 33173-3021

Mailing address

10300 SW 72ND St Ste 430
Miami, FL 33173-3021
Phone (786) 427-6644

Other identifiers 1

IdentifierTypeStateIssuer
272739100MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050624000206 FL Practitioner - Family PracticePractitioner - General PracticePractitioner - Geriatric Medicine 8325083058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10300 Sunset Dr
Suite 430
Miami, FL 33173-3021
Phone (786) 427-6644

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 91994FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avila Health Group LLC CurrentSince Jul 8, 2021 Accepting new patients
Ana J Fandino MD PA Family Medicine CurrentSince Apr 12, 2005 Accepting new patients

Locations

11402 NW 41st St
Unit 206
Doral, FL 33178
Phone (305) 373-3424

8323 NW 12th St
Ste 206
Doral, FL 33126
Phone (305) 373-3424

10300 Sunset Dr
Ste 430
Miami, FL 33173
Phone (305) 595-4433

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CIJDBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CIJDBD/Endpoint/CIJDBD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1033157938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 72ND ST STE 430",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733021",
            "telephone_number": "786-427-6644",
            "fax_number": "786-623-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 72ND ST STE 430",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733021",
            "telephone_number": "786-427-6644",
            "fax_number": "786-623-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANDINO",
        "first_name": "ANA",
        "middle_name": "JULIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 91994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272739100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.