Active NPI
Juan Manuel De Oleo, PA
- Physician Assistant
- Miami, FL
National Provider Identifier
1679767941
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Nov 20, 2011.
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9101496
- Practice address
- 600 NW 35TH Ave
Miami, FL 33125-4000 - Phone
- (305) 642-3724
- Fax
- (305) 643-2228
- NPI assigned
- Aug 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9101496 | FL | Primary |
Addresses
Primary practice location
600 NW 35TH Ave
Miami, FL 33125-4000
Mailing address
600 NW 35TH Ave
Miami, FL 33125-4000
Phone (305) 642-3724
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9101496 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188432000000",
"number": "1679767941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 NW 35TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331254000",
"telephone_number": "305-642-3724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 NW 35TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331254000",
"telephone_number": "305-642-3724",
"fax_number": "305-643-2228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE OLEO",
"first_name": "JUAN",
"middle_name": "MANUEL",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-30",
"last_updated": "2007-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9101496",
"primary": true
}
],
"identifiers": [],
"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 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.