Individual provider Active NPI

Luis Penate-Perez

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1053341214
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME93736 Issued in FL
Practice address
8200 SW 117TH Ave
Suite 112
Miami, FL 33183-3856
Phone
(305) 596-7432
Fax
(888) 715-1420
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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 ME93736 FL Primary

Addresses

Primary practice location

8200 SW 117TH Ave
Suite 112
Miami, FL 33183-3856

Mailing address

8200 SW 117TH Ave
Suite 112
Miami, FL 33183-1428
Phone (305) 596-7432

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
I20070410000435 FL Practitioner - Family Practice 0941200760 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME93736FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LC Health Management LLC Family Medicine CurrentSince Jul 25, 2023 Accepting new patients
LC Health Management LLC Family Medicine Current Accepting new patients
LC Health Management LLC Family Medicine Past Accepting new patients
LC Health Management LLC Past Accepting new patients
LC Health Management LLC Family Medicine Past Accepting new patients

Locations

18900 SW 106th Ave
Miami, FL 33157
Phone (708) 214-9956

8200 SW 117th Ave
Ste 112
Miami, FL 33183
Phone (305) 596-7432

4799 NW 183rd St
Miami Gardens, FL 33055
Phone (305) 787-3333

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1053341214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 SW 117TH AVE",
            "address_2": "SUITE 112",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331831428",
            "telephone_number": "305-596-7432",
            "fax_number": "888-715-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 SW 117TH AVE",
            "address_2": "SUITE 112",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331833856",
            "telephone_number": "305-596-7432",
            "fax_number": "888-715-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENATE-PEREZ",
        "first_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME93736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.