Fabio M Potenti, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

ME75795 Issued in FL

Practice address

2950 Cleveland Clinic Blvd
Weston, FL 33331-3609

Phone

(954) 689-5784

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1063448173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 CLEVELAND CLINIC BLVD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "33331",
            "telephone_number": "934-689-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 CLEVELAND CLINIC BLVD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313609",
            "telephone_number": "954-689-5784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTENTI",
        "first_name": "FABIO",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME75795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271217200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "50587",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH INC",
            "identifier": "0182289",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JACKSON MEMORIAL HEALTH",
            "identifier": "179405",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED HEALTH PLANS",
            "identifier": "294851",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "901933",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMUNITU CARE NETWORK",
            "identifier": "1048169",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "487353400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "48224",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stacey Ellen Portnoy, SLP
• Isaac Posada
• Bradley John Potsic, M.D.
• Enma F Poveda, M.D.
• Charles Walker Powell
• Tanique S Powell
• Victoria Powell, OTR/L

• Colon & Rectal Surgery Physician in Weston, FL
• Providers in Weston, FL by specialty
• Colon & Rectal Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.