Modern Urology Group LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

MODERN UROLOGY GROUP LLC

Doing business as

Modern Urology

Practice address

3400 Coral Way Ste 500
Miami, FL 33145-3053

Phone

(305) 603-8684

Fax

(833) 756-2656

NPI assigned

Mar 3, 2022

Organization subpart

No

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

Authorized official

Name

Adam Michael De FazioNPI 1366839573

Title

Authorized Official

Phone

(305) 215-7452

Specialties & licenses 1

Addresses

Other names 1

• Modern Urology Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• HealthSun Health Plans Network

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adam Michael De Fazio, MD

  • Urology Physician
  • Miami, FL
  • NPI 1366839573
  Medicare reassignment Care Compare group NPD Authorized official
• Jose Luis Vilaro Valderrabano, MD

  • Urology Physician
  • Miami, FL
  • NPI 1093127631
  Medicare reassignment Care Compare group NPD
• Angel Perez, ARNP

  • Nurse Practitioner
  • Miami, FL
  • NPI 1538446422
  Medicare reassignment NPD
• Augusto Tirado, MD

  • Urology Physician
  • Miami, FL
  • NPI 1619940665
  Medicare reassignment NPD
• Randy Lugo Rodriguez, APRN

  • Family Nurse Practitioner
  • Miami Beach, FL
  • NPI 1942974977
  Medicare reassignment

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1437806197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CORAL WAY STE 500",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331453053",
            "telephone_number": "305-603-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CORAL WAY STE 500",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331453053",
            "telephone_number": "305-603-8684",
            "fax_number": "833-756-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN UROLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "DE FAZIO",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-215-7452"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modern Urology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modern Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Urology Physician in Miami, FL
• Providers in Miami, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.