Individual provider Active NPI

Cecilia Grande, M.D.

  • Gynecology Physician
  • South Miami, FL
National Provider Identifier
1114949559
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
ME71900 Issued in FL
Practice address
7000 SW 62ND Ave Ste 400
South Miami, FL 33143-4717
Phone
(305) 856-1461
Fax
(305) 250-5216
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X ME71900 FL Primary

Addresses

Primary practice location

7000 SW 62ND Ave Ste 400
South Miami, FL 33143-4717

Mailing address

9905 SW 68TH CT
Pinecrest, FL 33156-3050
Phone (305) 856-1461

Other identifiers 1

IdentifierTypeStateIssuer
259082400MedicaidFL

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
I20040629000217 FL Practitioner - Obstetrics/Gynecology 9133105224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Puerto Rico School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

7000 SW 62 Ave
Miami, FL 33143-4717

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Obstetrics & Gynecology CurrentSince Feb 1, 2004 Accepting new patients

Locations

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

3659 S Miami Ave
Ste 6006
Miami, FL 33133
Phone (305) 856-1461

7000 SW 62nd Ave
Ste 400
South Miami, FL 33143
Phone (305) 665-0585

Interoperability endpoints

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

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1114949559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9905 SW 68TH CT",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331563050",
            "telephone_number": "305-856-1461",
            "fax_number": "305-662-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 SW 62ND AVE STE 400",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434717",
            "telephone_number": "305-856-1461",
            "fax_number": "305-250-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDE",
        "first_name": "CECILIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME71900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259082400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.