Banuelos Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME97139 Issued in FL

Legal business name

BANUELOS FAMILY MEDICINE, LLC

Practice address

6061 Doctors Park
Milton, FL 32570-5073

Phone

(850) 983-8500

Fax

(850) 983-0009

NPI assigned

Jan 24, 2013

Last updated

Jan 24, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Elias Ignacio Banuelos, MD

Title

Ceo

Phone

(850) 983-8500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1124366299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6061 DOCTORS PARK",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325705073",
            "telephone_number": "850-983-8500",
            "fax_number": "850-983-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6061 DOCTORS PARK",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325705073",
            "telephone_number": "850-983-8500",
            "fax_number": "850-983-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANUELOS FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "BANUELOS",
        "authorized_official_first_name": "ELIAS",
        "authorized_official_middle_name": "IGNACIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-983-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME97139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Dean Baker
• Kim Baker
• Kimberlee Baksh
• Ashley Nicole Balderas
• Christina Olivia Marie Baltimore Sr.
• Banuelos Psychiatric Mental Healthcare LLC
• Chad Michael Barden, APRN
• Samantha Rena Barfield, PHARMD
• Gracie Barnes
• James A Barnes, MD

• Family Medicine Physician in Milton, FL
• Providers in Milton, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.