Organization Active NPI

Francisco G Tudela M.D PA

  • Obstetrics & Gynecology Physician
  • Hialeah, FL
National Provider Identifier
1265733430
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
FRANCISCO G TUDELA M.D PA
Practice address
777 E 25TH St Ste 106
Hialeah, FL 33013-3804
Phone
(305) 691-1171
Fax
(305) 693-6726
NPI assigned
Nov 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Authorized official

Name
Mr. Francisco G Tudela Jr., M.DNPI 1538185707
Title
Owner
Phone
(305) 691-1171

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME36365 FL
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

777 E 25TH St Ste 106
Hialeah, FL 33013-3804

Mailing address

777 E 25TH St Ste 106
Hialeah, FL 33013-3804
Phone (305) 691-1171

Other practice location 1

11760 SW 40th St Ste 729
Miami, FL 33175-8102
Phone (305) 559-8787

Other identifiers 4

IdentifierTypeStateIssuer
1190HILHOtherFLNHP
95746OtherFLBCBS ID #
058554800MedicaidFL
209384OtherFLAVMED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110701000150 FL Part B Supplier - Clinic/Group Practice 1951589480 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory
Tax ID family
Francisco G Tudela Jr MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

777 E 25th St
Ste 106
Hialeah, FL 33013
Phone (305) 559-8787

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 3

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": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1265733430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 106",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133804",
            "telephone_number": "305-691-1171",
            "fax_number": "305-693-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 106",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133804",
            "telephone_number": "305-691-1171",
            "fax_number": "305-693-6726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11760 SW 40th St Ste 729",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331758102",
            "country_code": "US",
            "telephone_number": "305-559-8787",
            "fax_number": "844-798-8918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FRANCISCO G TUDELA M.D PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "TUDELA",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-691-1171",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME36365",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "1190HILH",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID #",
            "identifier": "95746",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058554800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "209384",
            "state": "FL"
        }
    ],
    "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 Nov 11, 2021; 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.