Fit Life Pediatric Consultants, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS10933 Issued in FL

Legal business name

FIT LIFE PEDIATRIC CONSULTANTS, LLC

Practice address

9020 SW 137TH Ave Ste 200
Miami, FL 33186-1430

Phone

(305) 777-3505

Fax

(786) 866-2599

NPI assigned

Feb 20, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Damaris Mafut, D.ONPI 1699976357

Title

President

Phone

(305) 777-3505

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Damaris Mafut, D.O.

  • Pediatrics Physician
  • Miami, FL
  • NPI 1699976357
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713571200000",
    "number": "1326587601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 SW 137TH AVE STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331861430",
            "telephone_number": "305-777-3505",
            "fax_number": "786-866-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 SW 137TH AVE STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331861430",
            "telephone_number": "305-777-3505",
            "fax_number": "786-866-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIT LIFE PEDIATRIC CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2024-04-20",
        "certification_date": "2024-04-20",
        "status": "A",
        "authorized_official_last_name": "MAFUT",
        "authorized_official_first_name": "DAMARIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-777-3505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS10933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020390800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beatriz Fisk
• Gregory Parker Fisk
• Taylor Fistel, MD
• Luciano Fiszer, MD
• Fit for L.Y.F.E
• Fit Medical Supply LLC
• Fitlife Behavioral Health LLC
• Fitness & Wellness Works, LLC
• Fitness & Wellness Works, LLC
• Fitness on Tap, LLC

• Pediatrics Physician in Miami, FL
• Providers in Miami, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2024; 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.