Individual provider Active NPI

Bianca Sonia Radut

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1205419595
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS19765 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1096
Phone
(412) 452-1668
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X OS19765 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X 342942 LA
Nuclear Medicine Physician 207U00000X OS19765 FL

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1096

Mailing address

11465 SW 45TH CT Unit 112
Miramar, FL 33025-7901
Phone (412) 452-1668

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL N/A
CONNECT URL N/A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230508001602 FL Practitioner - General Practice 1759746191
I20241022002999 LA Practitioner - General Practice 1759746191 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS19765FLMDNuclear Medicine Physician
342942LAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC General Practice CurrentSince Aug 10, 2024 Accepting new patients

Locations

201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 582-1416

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1205419595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11465 SW 45TH CT UNIT 112",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257901",
            "telephone_number": "412-452-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361096",
            "telephone_number": "412-452-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADUT",
        "first_name": "BIANCA",
        "middle_name": "SONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS19765",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "342942",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "FL",
            "license": "OS19765",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "234 E 149th St",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104515504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "1611 NW 12th Ave",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331361096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.