Organization Active NPI

Luis G Diaz Rangel MD PA

  • Hematology & Oncology Physician
  • Hialeah, FL
National Provider Identifier
1427254689
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME0052014 Issued in FL
Legal business name
LUIS G DIAZ RANGEL MD PA
Practice address
777 E 25TH St Ste 118
Hialeah, FL 33013-3804
Phone
(305) 693-1988
Fax
(305) 693-3941
NPI assigned
Jun 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Luis G Diaz Rangel, MD
Title
Owner
Phone
(305) 693-1988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RH0003X ME0052014 FL Primary

Addresses

Primary practice location

777 E 25TH St Ste 118
Hialeah, FL 33013-3804

Mailing address

777 E 25TH St Ste 118
Hialeah, FL 33013-3804
Phone (305) 693-1988

Other identifiers 1

IdentifierTypeStateIssuer
275393600MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040915000134 FL Part B Supplier - Clinic/Group Practice 7810964202 Receives reassigned benefits from 4 practitioners
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

777 E 25th St
Ste 411
Hialeah, FL 33013
Phone (305) 693-1988

Networks

  • HealthSun Health Plans Network

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": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1427254689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 118",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133804",
            "telephone_number": "305-693-1988",
            "fax_number": "305-693-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 118",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133804",
            "telephone_number": "305-693-1988",
            "fax_number": "305-693-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS G DIAZ RANGEL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "DIAZ RANGEL",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-693-1988",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME0052014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275393600",
            "state": "FL"
        }
    ],
    "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 Jan 23, 2019; 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.