Organization Active NPI

Luis R. Garcia-Mayol, MD PA

  • Nephrology Physician
  • Coral Gables, FL
National Provider Identifier
1366569055
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME0037831 Issued in FL
Legal business name
LUIS R. GARCIA-MAYOL, MD PA
Practice address
747 Ponce de Leon Blvd
Suite 605
Coral Gables, FL 33134-2049
Phone
(305) 445-4535
Fax
(305) 441-1879
NPI assigned
Mar 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Authorized official

Name
Luis R Garcia Mayol, MDNPI 1003816463
Title
Owner
Phone
(305) 445-4535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X ME0037831 FL Primary

Addresses

Primary practice location

747 Ponce de Leon Blvd
Suite 605
Coral Gables, FL 33134-2049

Mailing address

747 Ponce de Leon Blvd
Suite 605
Coral Gables, FL 33134-2049
Phone (305) 445-4535

Other identifiers 2

IdentifierTypeStateIssuer
95648OtherBLUE CROSS/ BLUE SHIELD
065186900MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110518000529 FL Part B Supplier - Clinic/Group Practice 2668658188 Receives reassigned benefits from 1 practitioner
Practice locations: Coral Gables, FL

National Provider Directory

National Provider Directory

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1366569055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 PONCE DE LEON BLVD",
            "address_2": "SUITE 605",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342049",
            "telephone_number": "305-445-4535",
            "fax_number": "305-441-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 PONCE DE LEON BLVD",
            "address_2": "SUITE 605",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342049",
            "telephone_number": "305-445-4535",
            "fax_number": "305-441-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS R. GARCIA-MAYOL, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "GARCIA MAYOL",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-445-4535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME0037831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "95648",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065186900",
            "state": "FL"
        }
    ],
    "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 May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.