Maricela Dianexi Fardales, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9103093 Issued in FL

Practice address

8051 W 24TH Ave Ste 9
Hialeah, FL 33016-5596

Phone

(305) 400-9702

Fax

(305) 735-7542

NPI assigned

Aug 11, 2006

Last updated

Jul 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• American Home Health Providers Corp Home health agency, Hialeah, FL, CCN 109554

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Fardales Medical Center Inc

  • Primary Care Clinic/Center
  • Hialeah, FL
  • NPI 1174990915
  Medicare reassignment Authorized official
• Victoria Medical Group Inc

  • Internal Medicine Physician
  • Miami Lakes, FL
  • NPI 1346321734
  Medicare reassignment
• Lisbet Rodriguez Boloix PA

  • Family Nurse Practitioner
  • Miami Lakes, FL
  • NPI 1619716495
  NPD (past)

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

• American Home Health Providers Corp

  • Home Health Agency
  • Hialeah, FL
  • NPI 1861668717
  Care Compare affiliation

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1457362410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8051 W 24TH AVE STE 9",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165596",
            "telephone_number": "305-400-9702",
            "fax_number": "305-735-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8051 W 24TH AVE STE 9",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330165596",
            "telephone_number": "305-400-9702",
            "fax_number": "305-735-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARDALES",
        "first_name": "MARICELA",
        "middle_name": "DIANEXI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004570500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maricela Faraco Collazo
• Farah Michelle Alf, Inc
• Farali Home for Erderly, Inc.
• Fardales Home Alf
• Fardales Medical Center Inc
• Farid Marquez, M.D., P.a.
• Dania Farigola, TCM SUPERVISOR
• Salomon Eli Farin, PHARM.D.
• Maria del Mar Farinas
• Farmacia 22-24 Hialeah Inc. (Farmacia 22-24 Hialeah)

• Medical Physician Assistant in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.