Individual provider Active NPI

Manuel Bouza, MD

  • Specialist
  • Hialeah, FL
National Provider Identifier
1497860928
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0052013 Issued in FL
Practice address
690 E 25TH St
Hialeah, FL 33013-3815
Phone
(305) 696-0331
Fax
(305) 696-1239
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0052013 FL Primary

Addresses

Primary practice location

690 E 25TH St
Hialeah, FL 33013-3815

Mailing address

690 E 25TH St
Hialeah, FL 33013-3815
Phone (305) 696-0331

Other identifiers 1

IdentifierTypeStateIssuer
064503600MedicaidFL

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
I20110808000565 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4183662141 Practice locations: Hialeah, FL

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

690 E 25TH St
Hialeah, FL 33013-3815
Phone (305) 696-0331

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bouza & Miralles Medical Associates Specialist Past Accepting new patients

Networks

  • HealthSun Health Plans Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1497860928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133815",
            "telephone_number": "305-696-0331",
            "fax_number": "305-696-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133815",
            "telephone_number": "305-696-0331",
            "fax_number": "305-696-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUZA",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0052013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064503600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.