NPIMap

Organization Active NPI

Pinecrest Pediatrics, P.a.

  • Pediatrics Physician
  • Hialeah, FL
National Provider Identifier
1417047184
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4648755 Issued in FL
Legal business name
PINECREST PEDIATRICS, P.A.
Practice address
18590 NW 67TH Ave
Suite # 101
Hialeah, FL 33015-3306
Phone
(305) 819-8633
Fax
(305) 819-8630
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lorraine Fuentes, MDNPI 1831289594
Title
President
Phone
(305) 819-8633

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 4648755 FL Primary

Addresses

Primary practice location

18590 NW 67TH Ave
Suite # 101
Hialeah, FL 33015-3306

Mailing address

PO Box 566417
Miami, FL 33256-6417
Phone (305) 819-8633

National Provider Directory

National Provider Directory

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417047184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 566417",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332566417",
            "telephone_number": "305-819-8633",
            "fax_number": "305-819-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18590 NW 67TH AVE",
            "address_2": "SUITE # 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330153306",
            "telephone_number": "305-819-8633",
            "fax_number": "305-819-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FUENTES",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-819-8633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "4648755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.