Individual provider Active NPI

Laura Eileen Irastorza, M.D.

  • Pediatric Gastroenterology Physician
  • Miami, FL
National Provider Identifier
1386025856
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME135905 Issued in FL
Practice address
3100 SW 62ND Ave
Miami, FL 33155-3009
Phone
(305) 662-8357
Fax
(305) 669-6406
NPI assigned
Jun 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME135905 FL Primary

Addresses

Primary practice location

3100 SW 62ND Ave
Miami, FL 33155-3009

Mailing address

3100 SW 62ND Ave
Miami, FL 33155-3009
Phone (305) 662-8357

Other practice location 1

1601 NW 12th Ave Ste 3005A
Miami, FL 33136-1005
Phone (305) 243-3166

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
I20230221000154 FL Practitioner - Gastroenterology 9234425018 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME135905FLMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami Pediatrics CurrentSince Mar 1, 2023 Accepting new patients
University of Miami Pediatric Gastroenterology CurrentSince Mar 1, 2023 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1601 NW 12th Ave
Ste 3005A
Miami, FL 33136
Phone (305) 243-3166

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1386025856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009",
            "telephone_number": "305-662-8357",
            "fax_number": "305-669-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009",
            "telephone_number": "305-662-8357",
            "fax_number": "305-669-6406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 NW 12th Ave Ste 3005A",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-243-3166",
            "fax_number": "305-243-2617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRASTORZA",
        "first_name": "LAURA",
        "middle_name": "EILEEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-10",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME135905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.