Organization Active NPI

Romualdo J. Segurola, Jr. M.D., P.a.

  • Interventional Cardiology Physician
  • Doral, FL
National Provider Identifier
1477629707
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
ROMUALDO J. SEGUROLA, JR. M.D., P.A.
Practice address
3650 NW 82ND Ave
Suite 208
Doral, FL 33166-6658
Phone
(305) 406-3596
Fax
(305) 406-3599
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Authorized official

Name
Karen Engen
Title
Administrator
Phone
(612) 669-7173

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X

Addresses

Primary practice location

3650 NW 82ND Ave
Suite 208
Doral, FL 33166-6658

Mailing address

3650 NW 82ND Ave
Suite 208
Doral, FL 33166-6658
Phone (305) 406-3596

Other identifiers 1

IdentifierTypeStateIssuer
277084900MedicaidFL

Other names 1

  • South Florida Heart and Lung Institute Doing business as

National Provider Directory

National Provider Directory

Locations

3650 NW 82nd Ave
Ste 208
Doral, FL 33166
Phone (305) 406-3596

400 W 41st St
Ste 310
Miami Beach, FL 33140
Phone (305) 538-6986

Practitioners & affiliated clinicians

Practitioners 2

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569456000000",
    "number": "1477629707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 NW 82ND AVE",
            "address_2": "SUITE 208",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666658",
            "telephone_number": "305-406-3596",
            "fax_number": "305-406-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 NW 82ND AVE",
            "address_2": "SUITE 208",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666658",
            "telephone_number": "305-406-3596",
            "fax_number": "305-406-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROMUALDO J. SEGUROLA, JR. M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2019-09-26",
        "status": "A",
        "authorized_official_last_name": "ENGEN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "612-669-7173"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277084900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Florida Heart and Lung Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Florida Heart and Lung Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.