Individual provider Active NPI

Gabriel Fidalgo, PT

  • Specialist
  • Coral Gables, FL
National Provider Identifier
1316144074
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT22033 Issued in FL
Practice address
3191 Coral Way Ste 109
Coral Gables, FL 33145-3219
Phone
(305) 447-8118
Fax
(305) 447-8114
NPI assigned
Jun 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT22033 FL Primary

Addresses

Primary practice location

3191 Coral Way Ste 109
Coral Gables, FL 33145-3219

Mailing address

3191 Coral Way Ste 109
Coral Gables, FL 33145-3219
Phone (305) 447-8118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201012000847 FL Practitioner - Physical Therapist in Private Practice 5092895110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Florida State University College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Specialists of South Miami, IncGroup PAC ID 5698739118, 2 clinicians

Practice addresses (Care Compare)

6705 S Red Rd
Suite 418
South Miami, FL 33143-3644
Phone (305) 669-4426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Specialists of South Miami, Inc Specialist CurrentSince Jul 9, 2020 Accepting new patients

Locations

6705 SW 57th Ave
Ste 418
South Miami, FL 33143
Phone (305) 669-4426

Organizations & group practices 1

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316144074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 CORAL WAY STE 109",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331453219",
            "telephone_number": "305-447-8118",
            "fax_number": "305-447-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 CORAL WAY STE 109",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331453219",
            "telephone_number": "305-447-8118",
            "fax_number": "305-447-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDALGO",
        "first_name": "GABRIEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PT22033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.