Individual provider Active NPI

Maria E. Fernandez Tamayo, M.D.

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1215940747
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME137016 Issued in FL
Practice address
Ultimate Medical Center & Spa. LLC.
12700 SW 128TH Street, Suite 205
Miami, FL 33186-5378
Phone
(305) 278-7579
Fax
(305) 278-7589
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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 ME137016 FL Primary

Addresses

Primary practice location

Ultimate Medical Center & Spa. LLC.
12700 SW 128TH Street, Suite 205
Miami, FL 33186-5378

Mailing address

13500 SW 88TH St Ste 175
Miami, FL 33186-1528
Phone (305) 387-0081

Other practice location 1

13500 SW 88th St Ste 175
Miami, FL 33186-1528
Phone (305) 387-0081

Other identifiers 3

IdentifierTypeStateIssuer
0083354OtherPRPTAN
9372OtherPRMEDICAL LICENCE
ME137016OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME137016FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Medical Center & Spa LLC General Practice CurrentSince Aug 1, 2020 Accepting new patients

Locations

12700 SW 128th St
Ste 205
Miami, FL 33186
Phone (305) 278-7579

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1215940747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 SW 88TH ST STE 175",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331861528",
            "telephone_number": "305-387-0081",
            "fax_number": "305-387-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ULTIMATE MEDICAL CENTER & SPA. LLC.",
            "address_2": "12700 SW 128TH STREET, SUITE 205",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865378",
            "telephone_number": "305-278-7579",
            "fax_number": "305-278-7589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13500 SW 88th St Ste 175",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331861528",
            "country_code": "US",
            "telephone_number": "305-387-0081",
            "fax_number": "305-387-0053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ TAMAYO",
        "first_name": "MARIA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME137016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0083354",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE",
            "identifier": "9372",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME137016",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.