Individual provider Active NPI

Andres Ozual, MD

  • General Practice Physician
  • Hollywood, FL
National Provider Identifier
1184739336
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN286 Issued in FL
Practice address
4801 Hollywood Blvd Ste B
Hollywood, FL 33021-6545
Phone
(954) 927-5905
Fax
(844) 546-1497
NPI assigned
Aug 20, 2006
Last updated
Jun 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 016372 PR
General Practice Physician 208D00000X ACN286 FL Primary

Addresses

Primary practice location

4801 Hollywood Blvd Ste B
Hollywood, FL 33021-6545

Mailing address

8752 NW 109TH Ter
Hialeah Gardens, FL 33018-4549
Phone (305) 804-8229

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
I20140422001833 FL Practitioner - General Practice 4880797265 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016372PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico Familiar Buen Pastor Inc General Practice CurrentSince Mar 24, 2014 Accepting new patients
Centro de Salud Primaria LLC General Practice CurrentSince May 11, 2017 Accepting new patients
Concepcion Medical LLC Past Accepting new patients
Cardio Neuro Medical Services Past Accepting new patients
Medical Cardiovascular Service Inc Past Accepting new patients

Locations

4440 Sheridan St
Ste C
Hollywood, FL 33021
Phone (954) 312-7041

4801 Hollywood Blvd
Ste B
Hollywood, FL 33021
Phone (954) 927-5382

Interoperability endpoints

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

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1184739336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8752 NW 109TH TER",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330184549",
            "telephone_number": "305-804-8229",
            "fax_number": "844-546-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 HOLLYWOOD BLVD STE B",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216545",
            "telephone_number": "954-927-5905",
            "fax_number": "844-546-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZUAL",
        "first_name": "ANDRES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "016372",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.