Organization Active NPI

Arles Perdomo MD PA

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1194464065
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ARLES PERDOMO MD PA
Practice address
777 E 25TH St Ste 502
Hialeah, FL 33013-3834
Phone
(305) 497-6688
Fax
(786) 553-2667
NPI assigned
May 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Arles Perdomo, MD,PANPI 1033218821
Title
Owner
Phone
(786) 683-1865

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

777 E 25TH St Ste 502
Hialeah, FL 33013-3834

Mailing address

777 E 25TH St Ste 502
Hialeah, FL 33013-3834
Phone (305) 497-6688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120711000197 FL Part B Supplier - Clinic/Group Practice 6800051129 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

5038 Coronado Pkwy
Naples, FL 34116
Phone (239) 234-6835

Practitioners & affiliated clinicians

Practitioners 5

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": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1194464065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 502",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133834",
            "telephone_number": "305-497-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 502",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133834",
            "telephone_number": "305-497-6688",
            "fax_number": "786-553-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARLES PERDOMO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-31",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "PERDOMO",
        "authorized_official_first_name": "ARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-683-1865",
        "authorized_official_credential": "MD,PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 10, 2024; 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.