Individual provider Active NPI

Mauricio Garcia Bango Sosa, PA-C

  • Urology Physician
  • Miami, FL
National Provider Identifier
1457118002
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
9118557 Issued in FL
Practice address
1150 NW 14TH St Ste 100
Miami, FL 33136-2112
Phone
(305) 243-7014
Fax
(305) 243-6597
NPI assigned
Feb 29, 2024
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NU
Urology Physician 208800000X 9118557 FL Primary

Addresses

Primary practice location

1150 NW 14TH St Ste 100
Miami, FL 33136-2112

Mailing address

1150 NW 14TH St Ste 100
Miami, FL 33136-2112
Phone (305) 243-7014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430000164 FL Practitioner - Physician Assistant 5799125340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1150 NW 14TH St
410 Pac
Miami, FL 33136-2115
Phone (305) 243-3100

1601 NW 12TH Ave
Miami, FL 33136-1005

1601 NW 12TH Ave 1St FL
Miami, FL 33136-1005

1601 NW 12TH Ave 1St FLR
Miami, FL 33136-1005

1601 NW 12TH Ave Room
2060 MCCD
Miami, FL 33136-1005
Phone (305) 585-5635

1601 NW 12TH Avenue 5065 /
5TH Mailman Center for Child Development
Miami, FL 33136-1005
Phone (305) 243-6251

1611 NW 12 Ave
Miami, FL 33136-1005

1611 NW 12 TH Ave
Jackson Memorial Hospital
Miami, FL 33136-1005
Phone (305) 355-5000

1611 NW 12TH
3B Jackson Memorial Hospital Acc West
Miami, FL 33136-1005
Phone (305) 585-7476

1611 NW 12TH Ave 2ND FL
Miami, FL 33136-1005

1611 NW 12TH Ave 2ND FLR
Miami, FL 33136-1005

1611 NW 12TH Ave 5TH Floor
Acc Clinic West JMH
Miami, FL 33136-1005
Phone (305) 243-4211

1611 NW 12TH Ave Acc E
Miami, FL 33136-1005

1611 NW 12TH Ave Acc E 2ND FLR
Miami, FL 33136-1005

1611 NW 12TH Ave Acc W
Miami, FL 33136-1005

1611 NW 12TH Ave Acc West
Miami, FL 33136-1005

1611 NW 12TH Ave Central
Miami, FL 33136-1005

1611 NW 12TH Ave DTC 1St FLR
JMH
Miami, FL 33136-1005
Phone (305) 585-6970

1611 NW 12TH Ave E
6006 Holtz Children's Hospital
Miami, FL 33136-1005
Phone (904) 697-3945

1611 NW 12TH Ave FL
3 Acc W. Jackson Memorial Hospital
Miami, FL 33136-1005
Phone (305) 355-5000

1611 NW 12TH Ave JMH
Miami, FL 33136-1005

1611 NW 12TH Ave JMH 5TH FL
Acc West
Miami, FL 33136-1005
Phone (305) 689-7303

1611 NW 12TH Ave N Wing
Miami, FL 33136-1005

1611 NW 12TH Ave-Nicu
JMH Holtz Children's Hospital
Miami, FL 33136-1005
Phone (305) 547-1496

8375 NW 53Rd Terr
Doral, FL 33166-4851
Phone (305) 689-8375

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9118557FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Mar 24, 2024 Accepting new patients
University of Miami CurrentSince Mar 24, 2024 Accepting new patients
University of Miami Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1150 NW 14th St
Ste 100
Miami, FL 33136
Phone (305) 243-1010

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1457118002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 NW 14TH ST STE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362112",
            "telephone_number": "305-243-7014",
            "fax_number": "305-243-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 NW 14TH ST STE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362112",
            "telephone_number": "305-243-7014",
            "fax_number": "305-243-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA BANGO SOSA",
        "first_name": "MAURICIO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "9118557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.