Individual provider Active NPI

Estilita Pascual, M.D.

  • General Practice Physician
  • Hialeah, FL
National Provider Identifier
1205935178
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME0063839 Issued in FL
Practice address
2100 W 76TH St FL 5
Hialeah, FL 33016-5539
Phone
(786) 536-9719
Fax
(786) 536-9830
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME0063839 FL Primary

Addresses

Primary practice location

2100 W 76TH St FL 5
Hialeah, FL 33016-5539

Mailing address

1470 NW 107TH Ave Ste G
Sweetwater, FL 33172-2734
Phone (786) 536-9719

Other identifiers 1

IdentifierTypeStateIssuer
109781900MedicaidFL

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
I20081118000129 FL Practitioner - General Practice 2860552171 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0063839FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Zion Health Care LLC Current Accepting new patients
Zion Health Care LLC General Practice CurrentSince Dec 20, 2016 Accepting new patients
MJ Medical and Dental Group Inc CurrentSince Oct 8, 2015 Accepting new patients
Estilita Pascual MD PA General Practice Past Accepting new patients
Medchoice of North Hialeah, L.L.C. Past Accepting new patients
Medchoice of West Hialeah LLC Past Accepting new patients

Locations

1578 W 68th St
Hialeah, FL 33014
Phone (305) 557-3889

2100 W 76th St
Fl 5
Hialeah, FL 33016
Phone (786) 536-9719

11389 W Flagler St
Miami, FL 33174
Phone (305) 480-2045

1470 NW 107th Ave
Ste G
Sweetwater, FL 33172
Phone (305) 594-8666

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1205935178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 NW 107TH AVE STE G",
            "city": "SWEETWATER",
            "state": "FL",
            "postal_code": "331722734",
            "telephone_number": "786-536-9719",
            "fax_number": "786-536-9847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W 76TH ST FL 5",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165539",
            "telephone_number": "786-536-9719",
            "fax_number": "786-536-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCUAL",
        "first_name": "ESTILITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0063839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109781900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.