Individual provider Active NPI

Steffanie Marie Mondelo, SA-C

  • Surgical Assistant
  • Miami, FL
National Provider Identifier
1356977060
Registry record updated Mar 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
20-157 Issued in FL
Practice address
17301 SW 119TH CT
Miami, FL 33177-2216
Phone
(848) 234-9717
NPI assigned
Mar 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 20-157 FL Primary

Addresses

Primary practice location

17301 SW 119TH CT
Miami, FL 33177-2216

Mailing address

17301 SW 119TH CT
Miami, FL 33177-2216
Phone (848) 234-9717

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

State licenses

LicenseStateTypeSpecialty
20-157FLMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1584144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584144000000",
    "number": "1356977060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17301 SW 119TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331772216",
            "telephone_number": "848-234-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17301 SW 119TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331772216",
            "telephone_number": "848-234-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDELO",
        "first_name": "STEFFANIE",
        "middle_name": "MARIE",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-14",
        "last_updated": "2020-03-14",
        "certification_date": "2020-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "20-157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Mar 14, 2020; 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.