NPIMap

Organization Active NPI

Randolph Borrero MD PA

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1245826569
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RANDOLPH BORRERO MD PA
Practice address
1190 NW 95TH St Ste 205
Miami, FL 33150-2064
Phone
(305) 835-7045
NPI assigned
Dec 21, 2020
Last updated
Dec 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Authorized official

Name
Dr. Randolph Borrero, MDNPI 1467871863
Title
Physician
Phone
(305) 495-3578

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1190 NW 95TH St Ste 205
Miami, FL 33150-2064

Mailing address

2570 SW 105TH Ter
Davie, FL 33324-7610
Phone (305) 495-3578

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210629000035 FL Part B Supplier - Clinic/Group Practice 5092116087 Receives reassigned benefits from 2 practitioners
Practice locations: Miami Lakes, FL; Miami Beach, FL; Miami, FL; Coral Gables, FL; Cutler Bay, FL; Hollywood, FL

National Provider Directory

National Provider Directory

Locations

1190 NW 95th St
Ste 205
Miami, FL 33150
Phone (305) 835-7045

1190 NW 95th St
Ste 207
Miami, FL 33150
Phone (305) 400-8518

1861 NW 8th Ave
Unit 321W
Miami, FL 33136
Phone (305) 347-3380

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608508800000",
    "number": "1245826569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 SW 105TH TER",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333247610",
            "telephone_number": "305-495-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST STE 205",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331502064",
            "telephone_number": "305-835-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH BORRERO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-21",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "BORRERO",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "305-495-3578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 21, 2020; 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.