Individual provider Active NPI

Adonis Pardo, DO,DPM

  • Family Medicine Physician
  • Cutler Bay, FL
National Provider Identifier
1669691572
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS 11446 Issued in FL
Practice address
10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone
(305) 253-5100
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO3287 FL
Family Medicine Physician 207Q00000X OS 11446 FL Primary

Addresses

Primary practice location

10300 SW 216TH St
Cutler Bay, FL 33190-1003

Mailing address

10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone (305) 253-5100

Other identifiers 2

IdentifierTypeStateIssuer
65955OtherFLBLUE CROSS BLUE SHIELD
278470000MedicaidFL

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS 11446FLMDFamily Medicine Physician
PO3287FLMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1669691572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-253-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-253-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDO",
        "first_name": "ADONIS",
        "name_prefix": "Dr.",
        "credential": "DO,DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3287",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 11446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "65955",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278470000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.