Individual provider Active NPI

Rusdany Collado Fuentes, MD

  • Neurology Physician
  • Miami, FL
National Provider Identifier
1164050001
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME159106 Issued in FL
Practice address
10621 N Kendall Dr Ste 200
Miami, FL 33176-1530
Phone
(786) 334-2494
Fax
(786) 221-2883
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME159106 FL
Neurology Physician 2084N0400X ME159106 FL Primary

Addresses

Primary practice location

10621 N Kendall Dr Ste 200
Miami, FL 33176-1530

Mailing address

13783 SW 66TH St Apt A219
Miami, FL 33183-2200
Phone (305) 502-3553

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
I20221018000130 FL Practitioner - NeurologyPractitioner - Internal Medicine 5890161749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13783 SW 66TH St
Apt A219
Miami, FL 33183-4516
Phone (305) 502-3553

Hospital & facility affiliations

  • Larkin Community Hospital Palm Springs Campus Hospital, Hialeah, FL, CCN 100050
  • Keralty Hospital Hospital, Miami, FL, CCN 100284
  • Homestead Hospital Hospital, Homestead, FL, CCN 100125
  • Larkin Community Hospital Hospital, South Miami, FL, CCN 100181
  • HCA Florida Kendall Hospital Hospital, Miami, FL, CCN 100209

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Equilibrium MD Corp Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Equilibrium Inn Corp Neurology Current Accepting new patients

Locations

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

Organizations & group practices 2

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 5

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1164050001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13783 SW 66TH ST APT A219",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331832200",
            "telephone_number": "305-502-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10621 N KENDALL DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761530",
            "telephone_number": "786-334-2494",
            "fax_number": "786-221-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLADO FUENTES",
        "first_name": "RUSDANY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME159106",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME159106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.