Organization Active NPI

Roberto J Fernandez MD PA

  • Gastroenterology Physician
  • Hialeah, FL
National Provider Identifier
1508152968
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME43363 Issued in FL
Legal business name
ROBERTO J FERNANDEZ MD PA
Practice address
135 W 49TH St
Hialeah, FL 33012-3711
Phone
(305) 822-1590
Fax
(305) 826-3177
NPI assigned
Jun 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Authorized official

Name
Roberto Fernandez, MDNPI 1275597692
Title
President
Phone
(305) 822-1590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X ME43363 FL Primary

Addresses

Primary practice location

135 W 49TH St
Hialeah, FL 33012-3711

Mailing address

PO Box 127008
Hialeah, FL 33012-1617
Phone (305) 822-1590

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111004000873 FL Part B Supplier - Clinic/Group Practice 2264604834 Receives reassigned benefits from 1 practitioner
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

777 E 25th St
Ste 210
Hialeah, FL 33013
Phone (305) 450-1389

4410 W 16th Ave
Ste 33
Hialeah, FL 33012
Phone (305) 827-2002

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 4

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": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1508152968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127008",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330121617",
            "telephone_number": "305-822-1590",
            "fax_number": "305-826-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123711",
            "telephone_number": "305-822-1590",
            "fax_number": "305-826-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTO J FERNANDEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-822-1590",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME43363",
            "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 Jun 23, 2011; 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.