Individual provider Active NPI

Andrea V Fuentes, PHARMD

  • Pharmacist
  • Miami, FL
National Provider Identifier
1275122624
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS60174 Issued in FL
Practice address
3601 Federal Hwy
Miami, FL 33137-3795
Phone
(305) 576-6611
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS60174 FL Primary

Addresses

Primary practice location

3601 Federal Hwy
Miami, FL 33137-3795

Mailing address

133 NE 2ND Ave Apt 1603
Miami, FL 33132-2912
Phone (954) 881-8862

Other identifiers 2

IdentifierTypeStateIssuer
PS60174OtherPHARMACIST LICENSE
PS60174OtherFLPHARMACIST LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ATHENA

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS60174FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1275122624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 NE 2ND AVE APT 1603",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331322912",
            "telephone_number": "954-881-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 FEDERAL HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373795",
            "telephone_number": "305-576-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "ANDREA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS60174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PS60174",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PS60174",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ATHENA",
            "affiliation": "N",
            "address_1": "3601 Federal Hwy",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331373795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 11, 2021; 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.