Individual provider Active NPI

Rafael A Antun, MD

  • Urology Physician
  • South Miami, FL
National Provider Identifier
1457309288
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME59386 Issued in FL
Practice address
7600 SW 57 Ave
Ste 213
South Miami, FL 33143-5408
Phone
(305) 548-4005
Fax
(305) 548-4055
NPI assigned
May 4, 2006
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X ME59386 FL
Urology Physician 208800000X ME0059386 FL
Urology Physician 208800000X ME59386 FL Primary

Addresses

Primary practice location

7600 SW 57 Ave
Ste 213
South Miami, FL 33143-5408

Mailing address

7600 SW 57 Ave
Ste 213
South Miami, FL 33143-5408
Phone (305) 548-4005

Other identifiers 2

IdentifierTypeStateIssuer
111349100MedicaidFL
052240600MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123001240 FL Practitioner - Urology 1355537895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2601 SW 37 Ave
Suite 905
Miami, FL 33133-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0059386FLMDUrology Physician
ME59386FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rafael Antun MD PA Urology CurrentSince Jul 21, 2010 Accepting new patients

Locations

1321 NW 14th St
Ste 303
Miami, FL 33125
Phone (305) 548-4005

2601 SW 37th Ave
Ste 905
Miami, FL 33133
Phone (305) 444-2920

7600 SW 57th Ave
Ste 213
South Miami, FL 33143
Phone (305) 548-4005

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1457309288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 SW 57 AVE",
            "address_2": "STE 213",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435408",
            "telephone_number": "305-548-4005",
            "fax_number": "305-548-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 SW 57 AVE",
            "address_2": "STE 213",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435408",
            "telephone_number": "305-548-4005",
            "fax_number": "305-548-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTUN",
        "first_name": "RAFAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME59386",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME0059386",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME59386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111349100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052240600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.