Individual provider Active NPI

Ana M Puga, MD

  • Pediatric Infectious Diseases Physician
  • Plantation, FL
National Provider Identifier
1689639163
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
ME64118 Issued in FL
Practice address
4101 NW 3Rd CT Ste 9
Plantation, FL 33317-2830
Phone
(754) 701-6911
Fax
(954) 595-2103
NPI assigned
Apr 19, 2006
Last updated
Apr 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X ME64118 FL Primary

Addresses

Primary practice location

4101 NW 3Rd CT Ste 9
Plantation, FL 33317-2830

Mailing address

4101 NW 3Rd CT Ste 9
Plantation, FL 33317-2830
Phone (754) 701-6911

Other identifiers 1

IdentifierTypeStateIssuer
377748100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040211000374 FL Practitioner - Pediatric MedicinePractitioner - Infectious Disease 4789578717 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME64118FLMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Care Resource Community Health Centers, Inc Current Accepting new patients
Care Resource Community Health Centers, Inc CurrentSince Mar 1, 2020 Accepting new patients
Care Resource Community Health Centers, Inc. CurrentSince Mar 1, 2020 Accepting new patients

Locations

3510 Biscayne Blvd
Miami, FL 33137
Phone 3055761234282

3801 Biscayne Blvd
Ste 220
Miami, FL 33137

871 W Oakland Park Blvd
Wilton Manors, FL 33311
Phone (954) 567-7141

Organizations & group practices 3

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1689639163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 NW 3RD CT STE 9",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172830",
            "telephone_number": "754-701-6911",
            "fax_number": "954-595-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NW 3RD CT STE 9",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172830",
            "telephone_number": "754-701-6911",
            "fax_number": "954-595-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGA",
        "first_name": "ANA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "FL",
            "license": "ME64118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377748100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.