Individual provider Active NPI

Olga Prada-Gonzalez, M.D.

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1487719142
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME056411 Issued in FL
Practice address
720 SW 58TH CT
Miami, FL 33144-3928
Phone
(305) 267-1705
Fax
(305) 267-1703
NPI assigned
Dec 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME056411 FL Primary

Addresses

Primary practice location

720 SW 58TH CT
Miami, FL 33144-3928

Mailing address

720 SW 58TH CT
Miami, FL 33144-3928
Phone (305) 267-1705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME056411FLMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1166832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487719142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 SW 58TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331443928",
            "telephone_number": "305-267-1705",
            "fax_number": "305-267-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 SW 58TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331443928",
            "telephone_number": "305-267-1705",
            "fax_number": "305-267-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADA-GONZALEZ",
        "first_name": "OLGA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME056411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.