Individual provider Active NPI

Gonzalo Estevez del Cristo, M.D.

  • Dermatology Physician
  • Hialeah, FL
National Provider Identifier
1689880031
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME0022726 Issued in FL
Practice address
44 E 5TH St
Hialeah, FL 33010-4842
Phone
(305) 888-9786
Fax
(305) 888-8243
NPI assigned
May 15, 2007
Last updated
Dec 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME0022726 FL Primary

Addresses

Primary practice location

44 E 5TH St
Hialeah, FL 33010-4842

Mailing address

44 E 5TH St
Hialeah, FL 33010-4842
Phone (305) 888-9786

Other identifiers 1

IdentifierTypeStateIssuer
054201600MedicaidFL

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 Medicine

State licenses

LicenseStateTypeSpecialty
22726FLMDMental Health Counselor
ME0022726FLMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1689880031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 E 5TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330104842",
            "telephone_number": "305-888-9786",
            "fax_number": "305-888-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 E 5TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330104842",
            "telephone_number": "305-888-9786",
            "fax_number": "305-888-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEVEZ DEL CRISTO",
        "first_name": "GONZALO",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0022726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054201600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.