Individual provider Active NPI

Muneebul Siddiqui, D.O.

  • Family Medicine Physician
  • South Miami, FL
National Provider Identifier
1073882908
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS15839 Issued in FL
Practice address
7031 SW 62ND Ave
South Miami, FL 33143-4701
Phone
(305) 284-7761
NPI assigned
Dec 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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 OS15839 FL Primary

Addresses

Primary practice location

7031 SW 62ND Ave
South Miami, FL 33143-4701

Mailing address

1435 W 49TH PL
Hialeah, FL 33012-3197

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
I20201216002209 FL Practitioner - Family Practice 7810309838 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS15839FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gilbert Leung MD PA CurrentSince Mar 10, 2025 Accepting new patients
Med Therapy & Spa, Inc. Family Medicine CurrentSince Jan 30, 2026 Accepting new patients
Complete Local Specialty Care, Inc Family Medicine PastSince Feb 12, 2024 Accepting new patients

Locations

888 NE 126th St
Ste 101
North Miami, FL 33161
Phone (305) 899-1406

7241 SW 63rd Ave
Ste 201
South Miami, FL 33143
Phone (305) 666-5454

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEGBA

Organizations & group practices 3

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": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1073882908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 W 49TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 SW 62ND AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434701",
            "telephone_number": "305-284-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MUNEEBUL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-21",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS15839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.