Miguel J. De Puigdorfila

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AP4157 Issued in FL

Practice address

837 S Main St
Wildwood, FL 34785-5302

Phone

(505) 900-1476

Fax

(352) 753-7141

NPI assigned

Jul 27, 2020

Last updated

Jul 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• 100 Physicians Medicine, LLC

  • Acupuncturist
  • Lady Lake, FL
  • NPI 1407508930
  NPD Authorized official

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1033728076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 S MAIN ST",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347855302",
            "telephone_number": "505-900-1476",
            "fax_number": "352-753-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 S MAIN ST",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347855302",
            "telephone_number": "505-900-1476",
            "fax_number": "352-753-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE PUIGDORFILA",
        "first_name": "MIGUEL",
        "middle_name": "J.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-27",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NM",
            "license": "DOM1263",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP4157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "AP4157",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Santiago Corrales Delgado I
• CR 125, LLC (Generations Senior Living at The Fairways)
• Tracy M. Creel, PA-C
• Ana Cristina Cruz, DC
• Angelo Anthony Darby, H.A.S.
• Neil Ivan Delos Reyes, PA-C
• Christine D Diaz
• Marybeth Dick, MSW
• Robert Dixon
• Dr. Aixa Long

• Acupuncturist in Wildwood, FL
• Providers in Wildwood, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.