Individual provider Active NPI

Manuel R Cotilla, M.D.

  • Pediatric Infectious Diseases Physician
  • Miami, FL
National Provider Identifier
1427044700
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
ME 87657 Issued in FL
Practice address
3200 SW 60TH CT
Suite 206
Miami, FL 33155-4000
Phone
(305) 662-8378
Fax
(305) 663-6829
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X ME 87657 FL Primary

Addresses

Primary practice location

3200 SW 60TH CT
Suite 206
Miami, FL 33155-4000

Mailing address

3200 SW 60TH CT
Suite 206
Miami, FL 33155-4000
Phone (305) 662-8378

Other identifiers 1

IdentifierTypeStateIssuer
267377100MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 87657FLMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Infectious Diseases Associates Inc Pediatric Infectious Diseases PastSince Feb 26, 2007 Accepting new patients

Organizations & group practices 1

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1427044700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SW 60TH CT",
            "address_2": "SUITE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554000",
            "telephone_number": "305-662-8378",
            "fax_number": "305-663-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SW 60TH CT",
            "address_2": "SUITE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554000",
            "telephone_number": "305-662-8378",
            "fax_number": "305-663-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTILLA",
        "first_name": "MANUEL",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "FL",
            "license": "ME 87657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267377100",
            "state": "FL"
        }
    ],
    "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 Oct 30, 2007; 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.