Raul San Juan

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS16495 Issued in FL

Practice address

4800 N Federal Hwy Ste 200
Fort Lauderdale, FL 33308-4611

Phone

(954) 771-2111

Fax

(954) 983-1152

NPI assigned

Mar 15, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

General Practice

Education

Nova Southeastern College of Osteo Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

David a Butler DO LLCGroup PAC ID 5092981118, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
• Lake Wales Health and Rehabilitation Center Nursing home, Lake Wales, FL, CCN 106069

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations (25 of 29)

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.

• David a Butler DO LLC

  • Family Medicine Physician
  • Port Charlotte, FL
  • NPI 1669759080
  Medicare reassignment Care Compare group NPD
• Altea Medical Florida PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Cloud, FL
  • NPI 1083493860
  Medicare reassignment NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366
  Medicare reassignment NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  FL

  Medicare reassignment NPD
• Healing Hands Medical LLC

  • Internal Medicine Physician
  • Winter Park, FL
  • NPI 1780489567
  NPD Authorized official
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Jacksonville, FL
  • NPI 1114434206
  NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Palmetto, FL
  • NPI 1841236247

  Internal Medicine

  NPD (past)

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

• Lake Wales Operating Group LLC

  • Skilled Nursing Facility
  • Lake Wales, FL
  • NPI 1790348829

  Nursing home

  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Boynton Beach, FL
  • NPI 1467507657
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Miami Lakes, FL
  • NPI 1528113792
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Melbourne, FL
  • NPI 1669548053
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Tallahassee, FL
  • NPI 1972555464
  Care Compare affiliation

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1124489331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N FEDERAL HWY STE 200",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084611",
            "telephone_number": "954-771-2111",
            "fax_number": "954-983-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 N FEDERAL HWY STE 200",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084611",
            "telephone_number": "954-771-2111",
            "fax_number": "954-983-1152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4613 S Orange Blossom Trl",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328391705",
            "country_code": "US",
            "telephone_number": "407-232-9833",
            "fax_number": "407-232-9829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAN JUAN",
        "first_name": "RAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-15",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS16495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Samper, LMHC
• Marianne Sampson, OT
• Samuel F Cox MD PA
• Alex Samuel
• Kalina San Jorge, BA
• Doreen Marie Sanabria, LCSW
• Sanay LLC
• Rafael Sanchez Rodriguez
• Yanireth Elodia Sanchez Urbina
• Amaury Ryan Sanchez-Cifuentes, DMD

• Internal Medicine Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.