Individual provider Active NPI

Miguel Angel Arredondo Lopez, APRN

  • Family Nurse Practitioner
  • Miami Gardens, FL
National Provider Identifier
1073295788
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11020980 Issued in FL
Practice address
18300 NW 62ND Ave Ste 300
Miami Gardens, FL 33015-8217
Phone
(305) 628-4600
Fax
(305) 628-8090
NPI assigned
Aug 2, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 11020980 FL Primary

Addresses

Primary practice location

18300 NW 62ND Ave Ste 300
Miami Gardens, FL 33015-8217

Mailing address

9015 SW 17TH CT
Miramar, FL 33025-7602
Phone (305) 588-2477

Other practice location 1

9015 SW 17th Ct
Miramar, FL 33025-7602
Phone (305) 558-2477

Other practice location 2

12741 Miramar Pkwy Ste 103
Miramar, FL 33027-2904
Phone (954) 433-9923

Other identifiers 1

IdentifierTypeStateIssuer
119478900MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821002360 FL Practitioner - Nurse Practitioner 3173985371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine of Miami Gardens IncGroup PAC ID 1052355427, 3 clinicians

Practice addresses (Care Compare)

18300 NW 62ND Ave
Suite 300
Hialeah, FL 33015-8217
Phone (305) 628-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11020980FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatology & Arthritis Consultants of So Florida LLC Single Specialty CurrentSince Aug 10, 2023 Accepting new patients
Internal Medicine of Miami Gardens Inc Single Specialty CurrentSince Aug 10, 2023 Accepting new patients

Locations

18300 NW 62nd Ave
Ste 300
Miami Gardens, FL 33015
Phone (305) 628-4600

12741 Miramar Pkwy
Ste 103
Miramar, FL 33027
Phone (954) 433-9923

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1073295788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 SW 17TH CT",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257602",
            "telephone_number": "305-588-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 NW 62ND AVE STE 300",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330158217",
            "telephone_number": "305-628-4600",
            "fax_number": "305-628-8090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9015 SW 17th Ct",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330257602",
            "country_code": "US",
            "telephone_number": "305-558-2477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12741 Miramar Pkwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330272904",
            "country_code": "US",
            "telephone_number": "954-433-9923",
            "fax_number": "954-450-0537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARREDONDO LOPEZ",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11020980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119478900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.