Organization Active NPI

Roberto Sotolongo MD PA

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1689998247
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
102263 Issued in FL
Legal business name
ROBERTO SOTOLONGO MD PA
Practice address
11760 SW 156TH CT
Miami, FL 33196-6896
Phone
(787) 421-3758
Fax
(786) 787-7359
NPI assigned
Mar 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Dr. Roberto Sotolongo, MDNPI 1013166156
Title
President
Phone
(787) 421-3758

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 102263 FL Primary

Addresses

Primary practice location

11760 SW 156TH CT
Miami, FL 33196-6896

Mailing address

11760 SW 156TH CT
Miami, FL 33196-6896
Phone (787) 421-3758

Other identifiers 1

IdentifierTypeStateIssuer
000627400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121019000651 FL Part B Supplier - Clinic/Group Practice 2769632165 Receives reassigned benefits from 1 practitioner
Practice locations: Homestead, FL; South Miami, FL; Miami, FL; Coral Gables, FL

National Provider Directory

National Provider Directory

Locations

9835 SW 72nd St
Ste 201
Miami, FL 33173
Phone (305) 271-6513

Practitioners & affiliated clinicians

Practitioners 1

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": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1689998247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11760 SW 156TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331966896",
            "telephone_number": "787-421-3758",
            "fax_number": "786-787-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 SW 156TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331966896",
            "telephone_number": "787-421-3758",
            "fax_number": "786-787-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTO SOTOLONGO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "SOTOLONGO",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-421-3758",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "102263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000627400",
            "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 Sep 18, 2012; 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.