Organization Active NPI

Jorge E Ravelo MD PA

  • Specialist
  • Hialeah, FL
National Provider Identifier
1487954467
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME 56847 Issued in FL
Legal business name
JORGE E RAVELO MD PA
Practice address
2140 W 68TH St
Suite 307
Hialeah, FL 33016-1815
Phone
(305) 231-1664
Fax
(305) 231-9882
NPI assigned
Oct 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Mrs. Rosa Maria Ravelo
Title
Office Manager
Phone
(305) 231-1664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME 56847 FL Primary

Addresses

Primary practice location

2140 W 68TH St
Suite 307
Hialeah, FL 33016-1815

Mailing address

2140 W 68TH St
Suite 307
Hialeah, FL 33016-1815
Phone (305) 231-1664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110412000352 FL Part B Supplier - Clinic/Group Practice 2769666080 Receives reassigned benefits from 1 practitioner
Practice locations: Hialeah, FL; Miramar, FL

National Provider Directory

National Provider Directory

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": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1487954467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 W 68TH ST",
            "address_2": "SUITE 307",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161815",
            "telephone_number": "305-231-1664",
            "fax_number": "305-231-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 W 68TH ST",
            "address_2": "SUITE 307",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161815",
            "telephone_number": "305-231-1664",
            "fax_number": "305-231-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORGE E RAVELO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "RAVELO",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-231-1664",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME 56847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.