Individual provider Active NPI

Yusdeny Fajardo, V.P.

  • General Practice Physician
  • Doral, FL
National Provider Identifier
1588690200
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME37781 Issued in FL
Practice address
3900 NW 79TH Ave
Suite 322
Doral, FL 33166-6556
Phone
(305) 471-9500
Fax
(305) 471-9870
NPI assigned
Jun 24, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME37781 FL Primary

Addresses

Primary practice location

3900 NW 79TH Ave
Suite 322
Doral, FL 33166-6556

Mailing address

3900 NW 79TH Ave
Suite 322
Doral, FL 33166-6556
Phone (305) 471-9500

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ME37781FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Aid Inc General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1588690200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE",
            "address_2": "SUITE 322",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666556",
            "telephone_number": "305-471-9500",
            "fax_number": "305-471-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE",
            "address_2": "SUITE 322",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666556",
            "telephone_number": "305-471-9500",
            "fax_number": "305-471-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "YUSDENY",
        "name_prefix": "Mr.",
        "credential": "V.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME37781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.