Active NPI
Florida International University Board of Trustees
- Family Medicine Physician
- Miami, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FLORIDA INTERNATIONAL UNIVERSITY BOARD OF TRUSTEES
- Practice address
- 800 SW 108TH Ave Ste 100
Miami, FL 33174-2555 - Phone
- (305) 348-3627
- Fax
- (305) 348-4261
- NPI assigned
- Aug 11, 2010
- Last updated
- Aug 4, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth A. Jessell
- Title
- Fiu Chief Financial Officer and Sen
- Phone
- (305) 348-2101
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | |||
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Infectious Disease Physician | 207RI0200X | |||
| Rheumatology Physician | 207RR0500X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Gynecology Physician | 207VG0400X | |||
| Gynecologic Oncology Physician | 207VX0201X | |||
| Psychiatry Physician | 2084P0800X | |||
| Child & Adolescent Psychiatry Physician | 2084P0804X | |||
| Diagnostic Ultrasound Physician | 2085U0001X | |||
| Surgery Physician | 208600000X | |||
| Hospitalist Physician | 208M00000X | |||
| Physician Assistant | 363A00000X |
Addresses
Primary practice location
800 SW 108TH Ave Ste 100
Miami, FL 33174-2555
Mailing address
11200 SW 8TH Street
Ahc 2 693
Miami, FL 33199
Phone (305) 348-3627
Other practice location 1
1600 S Andrews Ave Ste 1090
Ft Lauderdale, FL 33316-2510
Phone (954) 523-2727
Other practice location 2
1611 NW 12th Ave
Miami, FL 33136-1005
Phone (305) 348-3726
Other practice location 3
11200 SW 8th St # 2693
Miami, FL 33199-0001
Phone (305) 348-3627
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1600 S Andrews Ave
#1090
Ft Lauderdale, FL 33316
Phone (954) 523-2727
11200 SW 8th St
#22693
Miami, FL 33199
1350 NW 14th St
#3
Miami, FL 33125
Phone (305) 575-3890
800 SW 108th Ave
#100
Miami, FL 33174
Phone (305) 348-0254
9200 SW 72nd St
#4
Miami, FL 33173
Phone (305) 412-8315
Networks
- HealthSun Health Plans Network
Practitioners & affiliated clinicians
Practitioners 32
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.
-
- Internal Medicine Physician
- Miami, FL
- NPI 1043410699
-
- Family Medicine Physician
- Miami, FL
- NPI 1982099669
-
- Family Medicine Physician
- Miami, FL
- NPI 1639532575
-
- Medical Oncology Physician
- Miami, FL
- NPI 1447347851
-
- Family Medicine Physician
- Miami, FL
- NPI 1235499542
-
- Family Medicine Physician
- Miami, FL
- NPI 1073578373
-
- Psychiatry Physician
- Hialeah, FL
- NPI 1881866796
-
- Internal Medicine Physician
- Miami, FL
- NPI 1447213335
-
- Internal Medicine Physician
- Miami, FL
- NPI 1417511338
-
- Dermatology Physician
- Miami, FL
- NPI 1194122770
-
- Psychiatric/Mental Health Nurse Practitioner
- Miami, FL
- NPI 1508239872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281484800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1659571200000",
"number": "1598070849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11200 SW 8TH STREET",
"address_2": "AHC 2 693",
"city": "MIAMI",
"state": "FL",
"postal_code": "33199",
"telephone_number": "305-348-3627",
"fax_number": "305-348-4261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 SW 108TH AVE STE 100",
"city": "MIAMI",
"state": "FL",
"postal_code": "331742555",
"telephone_number": "305-348-3627",
"fax_number": "305-348-4261"
}
],
"practiceLocations": [
{
"address_1": "1600 S Andrews Ave Ste 1090",
"address_purpose": "LOCATION",
"city": "Ft Lauderdale",
"state": "FL",
"postal_code": "333162510",
"country_code": "US",
"telephone_number": "954-523-2727",
"fax_number": "954-523-8814",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1611 NW 12th Ave",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331361005",
"country_code": "US",
"telephone_number": "305-348-3726",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11200 SW 8th St # 2693",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331990001",
"country_code": "US",
"telephone_number": "305-348-3627",
"fax_number": "305-348-4261",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "FLORIDA INTERNATIONAL UNIVERSITY BOARD OF TRUSTEES",
"organizational_subpart": "NO",
"enumeration_date": "2010-08-11",
"last_updated": "2022-08-04",
"certification_date": "2022-08-03",
"status": "A",
"authorized_official_last_name": "JESSELL",
"authorized_official_first_name": "KENNETH",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "FIU CHIEF FINANCIAL OFFICER AND SEN",
"authorized_official_telephone_number": "305-348-2101"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Rheumatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207VX0201X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecologic Oncology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Ultrasound",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
- Florida International Medical Research, LLC.
- Florida International Ultrasound
- Florida International University (University Health Services)
- Florida International University (FIU Sports Medicine)
- Florida International University
- Florida International University Board of Trustees Center for Children (FIU Center for Children and Families)
- Florida Kids Behavioral Analysis Corp
- Florida Managed Care Systems
- Florida Med-Care, Inc
- Florida Med-Physical Rehab
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; 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.