Organization Active NPI

Ana J Fandino MD PA

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1639102155
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME91994 Issued in FL
Legal business name
ANA J FANDINO MD PA
Practice address
9780 SW 24TH St
Miami, FL 33165-7574
Phone
(305) 551-5051
Fax
(305) 551-8808
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Ana Julia Fandino, MDNPI 1033157938
Title
President
Phone
(305) 551-5051

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME91994 FL Primary

Addresses

Primary practice location

9780 SW 24TH St
Miami, FL 33165-7574

Mailing address

9780 SW 24TH St
Miami, FL 33165-7574
Phone (305) 551-5051

Other identifiers 1

IdentifierTypeStateIssuer
272739100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050623000218 FL Part B Supplier - Clinic/Group Practice 4789629411 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

9780 SW 24th St
Miami, FL 33165
Phone (305) 551-5051

10281 Sunset Dr
Ste 101
Miami, FL 33173
Phone (305) 207-2500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CIJDBD

Practitioners & affiliated clinicians

Practitioners 2

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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1639102155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9780 SW 24TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657574",
            "telephone_number": "305-551-5051",
            "fax_number": "305-551-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9780 SW 24TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657574",
            "telephone_number": "305-551-5051",
            "fax_number": "305-551-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANA J FANDINO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "FANDINO",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "JULIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-551-5051",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME91994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272739100",
            "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 Aug 17, 2007; 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.