Individual provider Active NPI

Cesare Rzadkowolski Raoli, M.D.

  • Psychiatry Physician
  • Miami, FL
National Provider Identifier
1306975305
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME60415 Issued in FL
Practice address
12315 SW 64TH Ave
Miami, FL 33156-5538
Phone
(305) 631-0202
Fax
(305) 668-6277
NPI assigned
Mar 5, 2007
Last updated
Nov 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME60415 FL Primary

Addresses

Primary practice location

12315 SW 64TH Ave
Miami, FL 33156-5538

Mailing address

2001 NW 7TH St
Suite 300
Miami, FL 33125-3479
Phone (305) 631-0202

Other identifiers 2

IdentifierTypeStateIssuer
ME60415OtherFLSTATE LICENSE NUMBER
14460OtherFLBCBS PROVIDER NUMBER

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
I20040427000425 FL Practitioner - Psychiatry 7214924802 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Therapy and Medical Care Center IncGroup PAC ID 1557598182, 7 clinicians

Practice addresses (Care Compare)

1140 W 50TH St
Suite 301
Hialeah, FL 33012-3411
Phone (305) 827-0208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME60415FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Collaborative Care Solutions, LLC Psychiatry CurrentSince Feb 12, 2020 Accepting new patients
Wellness Therapy & Medical Care Center Inc CurrentSince Nov 17, 2021 Accepting new patients
Acevedo Medical Care Group Inc PastSince Feb 18, 2013 Accepting new patients
Complete Medical Rehab & Family Past Accepting new patients

Locations

1140 W 50th St
Ste 301
Hialeah, FL 33012
Phone (305) 558-2930

9000 SW 137th Ave
Ste 103
Miami, FL 33186
Phone (305) 671-3503

8040 NW 155th St
Miami Lakes, FL 33016
Phone (305) 827-0208

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1306975305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 NW 7TH ST",
            "address_2": "SUITE 300",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331253479",
            "telephone_number": "305-631-0202",
            "fax_number": "305-668-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12315 SW 64TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565538",
            "telephone_number": "305-631-0202",
            "fax_number": "305-668-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RZADKOWOLSKI RAOLI",
        "first_name": "CESARE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME60415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "ME60415",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "14460",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.