Individual provider Active NPI

Marieny E Guimera-Revelo, M.D

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1063773539
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME124324 Issued in FL
Practice address
680 N University Dr
Pembroke Pines, FL 33024-6738
Phone
(954) 981-2555
Fax
(954) 538-6850
NPI assigned
May 31, 2012
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME124324 FL Primary

Addresses

Primary practice location

680 N University Dr
Pembroke Pines, FL 33024-6738

Mailing address

8333 NW 53Rd St FL 6
Doral, FL 33166-4783

Other identifiers 1

IdentifierTypeStateIssuer
117778400MedicaidFL

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
I20151109001770 FL Practitioner - Internal Medicine 5395964605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cano Health, LLCGroup PAC ID 1759565047, 141 clinicians

Practice addresses (Care Compare)

680 N University Dr
Pembroke Pines, FL 33024-6738
Phone 95451493608300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME124324FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
QMC LLC CurrentSince Jul 21, 2020 Accepting new patients
Primary Care Providers of America, LLC Internal Medicine CurrentSince Aug 1, 2017 Accepting new patients
Cano Health, LLC CurrentSince Feb 1, 2021 Accepting new patients
Primary Care Physicians Group Past Accepting new patients

Locations

8333 NW 53rd St
Fl 6
Doral, FL 33166

9725 NW 117th Ave
Ste 200
Medley, FL 33178
Phone 9545149360 ext. 8515

5201 Blue Lagoon Dr
Fl 9
Miami, FL 33126
Phone (786) 334-1757

18459 Pines Blvd
Pembroke Pines, FL 33029
Phone (954) 990-0595

3157 N University Dr
Ste 107
Pembroke Pines, FL 33024
Phone (954) 990-0595

680 N University Dr
Pembroke Pines, FL 33024
Phone (954) 538-6868

6931 W Sunrise Blvd
Plantation, FL 33313
Phone (954) 583-6200

7031 SW 62nd Ave
South Miami, FL 33143
Phone (305) 284-7585

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: marieny.guimerarevelo@chealth.eclinicaldirectplus.com

Organizations & group practices 4

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": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1063773539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NW 53RD ST FL 6",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331664783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246738",
            "telephone_number": "954-981-2555",
            "fax_number": "954-538-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIMERA-REVELO",
        "first_name": "MARIENY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME124324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117778400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.