Individual provider Active NPI

Rafael Junco, M.D.

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1194016378
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME120311 Issued in FL
Practice address
2750 W 68TH St Ste 127-128
Hialeah, FL 33016-5446
Phone
(305) 633-3776
Fax
(305) 633-4240
NPI assigned
Apr 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME120311 FL Primary

Addresses

Primary practice location

2750 W 68TH St Ste 127-128
Hialeah, FL 33016-5446

Mailing address

2750 W 68TH St Ste 127-128
Hialeah, FL 33016-5446
Phone (305) 558-0765

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
I20141215000644 FL Practitioner - Internal Medicine 0840512208 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME120311FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Las Mercedes, LLC CurrentSince Sep 9, 2014 Accepting new patients
Clinica Las Mercedes, LLC CurrentSince Sep 9, 2014 Accepting new patients
Clinica Las Mercedes, LLC Current Accepting new patients

Locations

2750 W 68th St
Ste 127128
Hialeah, FL 33016
Phone (305) 558-0765

1479 NW 27th Ave
Miami, FL 33125
Phone (305) 633-3776

6355 NW 36th St
Ste 1100
Virginia Gardens, FL 33166

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1194016378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 W 68TH ST STE 127-128",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165446",
            "telephone_number": "305-558-0765",
            "fax_number": "305-558-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W 68TH ST STE 127-128",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165446",
            "telephone_number": "305-633-3776",
            "fax_number": "305-633-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNCO",
        "first_name": "RAFAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-22",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME120311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.