Organization Active NPI

Rolando C Mendizabal MD PA

  • Specialist
  • Miami, FL
National Provider Identifier
1568580983
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME26739 Issued in FL
Legal business name
ROLANDO C MENDIZABAL MD PA
Practice address
1295 NW 14TH St
Suite I
Miami, FL 33125-1610
Phone
(305) 325-4541
Fax
(305) 324-5327
NPI assigned
Mar 26, 2007
Last updated
Jul 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Authorized official

Name
Dr. Rolando Cesar Mendizabal, M.D.NPI 1023007119
Title
President
Phone
(305) 325-4541

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X ME26739 FL Primary

Addresses

Primary practice location

1295 NW 14TH St
Suite I
Miami, FL 33125-1610

Mailing address

1295 NW 14TH St
Suite I
Miami, FL 33125-1610
Phone (305) 325-4541

Other identifiers 1

IdentifierTypeStateIssuer
035560700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100712000196 FL Part B Supplier - Clinic/Group Practice 3072645050 Receives reassigned benefits from 1 practitioner
Practice locations: Coral Gables, FL; Miami, FL

National Provider Directory

National Provider Directory

Locations

1295 NW 14th St
Ste I
Miami, FL 33125
Phone (305) 325-4541

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1568580983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 NW 14TH ST",
            "address_2": "SUITE I",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251610",
            "telephone_number": "305-325-4541",
            "fax_number": "305-324-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 NW 14TH ST",
            "address_2": "SUITE I",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251610",
            "telephone_number": "305-325-4541",
            "fax_number": "305-324-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLANDO C MENDIZABAL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2010-07-16",
        "status": "A",
        "authorized_official_last_name": "MENDIZABAL",
        "authorized_official_first_name": "ROLANDO",
        "authorized_official_middle_name": "CESAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-325-4541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME26739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035560700",
            "state": "FL"
        }
    ],
    "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 16, 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.