Organization Active NPI

Equilibrium MD Corp

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1396599577
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EQUILIBRIUM MD CORP
Practice address
11440 N Kendall Dr Ste 110
Miami, FL 33176-1024
Phone
(786) 334-2494
Fax
(786) 221-2883
NPI assigned
Apr 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Authorized official

Name
Rusdany Collado Fuentes, MDNPI 1164050001
Title
Owner
Phone
(305) 502-3553

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

11440 N Kendall Dr Ste 110
Miami, FL 33176-1024

Mailing address

13783 SW 66TH St Apt A219
Miami, FL 33183-4516

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240827004603 FL Part B Supplier - Clinic/Group Practice 8921547548 Receives reassigned benefits from 5 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

11440 N Kendall Dr
Ste 110
Miami, FL 33176
Phone (786) 699-1377

Practitioners & affiliated clinicians

Practitioners 5

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": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785715200000",
    "number": "1396599577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13783 SW 66TH ST APT A219",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331834516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11440 N KENDALL DR STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761024",
            "telephone_number": "786-334-2494",
            "fax_number": "786-221-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUILIBRIUM MD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A",
        "authorized_official_last_name": "COLLADO FUENTES",
        "authorized_official_first_name": "RUSDANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-502-3553",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Aug 3, 2026; 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.