Organization Active NPI

Antonio Mora MD PA

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1255580437
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0056780 Issued in FL
Legal business name
ANTONIO MORA MD PA
Practice address
1435 W 49TH PL
Suite 305
Hialeah, FL 33012-3197
Phone
(305) 251-3991
Fax
(305) 251-7982
NPI assigned
Sep 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Authorized official

Name
Antonio Mora, MDNPI 1891729919
Title
Medical Doctor
Phone
(305) 251-3991

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 ME0056780 FL Primary

Addresses

Primary practice location

1435 W 49TH PL
Suite 305
Hialeah, FL 33012-3197

Mailing address

1435 W 49TH PL
Suite 305
Hialeah, FL 33012-3197
Phone (305) 251-3991

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100924001220 FL Part B Supplier - Clinic/Group Practice 7416073648 Receives reassigned benefits from 1 practitioner
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

2770 W 2nd Ave
Hialeah, FL 33010
Phone (786) 452-1759

1435 W 49th Pl
Ste 305
Hialeah, FL 33012
Phone (305) 556-9200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1255580437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 W 49TH PL",
            "address_2": "SUITE 305",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123197",
            "telephone_number": "305-251-3991",
            "fax_number": "305-251-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 W 49TH PL",
            "address_2": "SUITE 305",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123197",
            "telephone_number": "305-251-3991",
            "fax_number": "305-251-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTONIO MORA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-12",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "MORA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "305-251-3991",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0056780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; 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.