Organization Active NPI

Azul Medical Center Corp

  • Internal Medicine Physician
  • Hialeah, FL
National Provider Identifier
1154917615
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
AZUL MEDICAL CENTER CORP
Practice address
1550 W 84TH St
Hialeah, FL 33014-3377
Phone
(305) 992-0867
NPI assigned
Dec 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Authorized official

Name
Erik Carrasco, MDNPI 1073762043
Title
Medical Provider
Phone
(305) 992-0867

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1550 W 84TH St
Hialeah, FL 33014-3377

Mailing address

8350 NW 157TH Ter
Miami Lakes, FL 33016-6601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210309001624 FL Part B Supplier - Clinic/Group Practice 1355757790 Receives reassigned benefits from 1 practitioner
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

1550 W 84th St
Hialeah, FL 33014
Phone (305) 308-8068

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1154917615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 NW 157TH TER",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330166601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 W 84TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330143377",
            "telephone_number": "305-992-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZUL MEDICAL CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "CARRASCO",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "MEDICAL PROVIDER",
        "authorized_official_telephone_number": "305-992-0867",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.