Individual provider Active NPI

Dan Sotolongo Jimenez, MD

  • Family Medicine Physician
  • South Miami, FL
National Provider Identifier
1245755958
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME161126 Issued in FL
Practice address
5975 Sunset Dr Ste 402
South Miami, FL 33143-5198
Phone
(305) 669-2833
NPI assigned
Aug 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036153273 IL
Student in an Organized Health Care Education/Training Program 390200000X 125.071569 IL
Family Medicine Physician 207Q00000X ME161126 FL Primary

Addresses

Primary practice location

5975 Sunset Dr Ste 402
South Miami, FL 33143-5198

Mailing address

15338 SW 141St CT
Miami, FL 33177-0916

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
I20230728002377 FL Practitioner - Family Practice 9931460748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Criticare Clinics IncGroup PAC ID 7517966534, 104 clinicians

Practice addresses (Care Compare)

10 Giralda Ave
Coral Gables, FL 33134-5303
Phone (786) 467-5000

1240 S Dixie Hwy
Coral Gables, FL 33146-2902
Phone (786) 467-5080

14701 NW 77TH Ave
Miami Lakes, FL 33014-2500
Phone (786) 662-0700

2660 Brickell Ave
Miami, FL 33129-2800
Phone (786) 467-5320

6300 S Dixie Hwy 100
South Miami UC
South Miami, FL 33143-4934
Phone (786) 467-5080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME161126FLMDFamily Medicine Physician
125.071569ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Criticare Clinics Inc CurrentSince Jun 15, 2023 Accepting new patients
Pedem PLLC PastSince Jun 18, 2023 Accepting new patients

Locations

4741 S University Dr
Davie, FL 33328
Phone (954) 837-1050

14701 NW 77th Ave
Miami Lakes, FL 33014
Phone (305) 669-2833

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1245755958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15338 SW 141ST CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331770916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5975 SUNSET DR STE 402",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435198",
            "telephone_number": "305-669-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTOLONGO JIMENEZ",
        "first_name": "DAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-03",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036153273",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125.071569",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME161126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.