Eduardo Fanilla, MD

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

ME82787 Issued in FL

Practice address

6963 SW 117TH Ave
Miami, FL 33183-2803

Phone

(786) 595-3225

Fax

(786) 595-7812

NPI assigned

Jun 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Miami Criticare Inc.

  • Emergency Medicine Physician
  • South Miami, FL
  • NPI 1306878210
  Medicare reassignment NPD

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1699710905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 SW 124TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865476",
            "telephone_number": "786-573-3152",
            "fax_number": "786-573-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6963 SW 117TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331832803",
            "telephone_number": "786-595-3225",
            "fax_number": "786-595-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANILLA",
        "first_name": "EDUARDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME82787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262088000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aimee Patricia Faneyte, RBT
• Julie Fanfan, FNP-BC
• Sage Sade Fanfan
• Jesica Analia Fanfliet
• Maylen Fang Tac Sabariego
• Arelys Carmen Fanjul Broche
• Jessica Fanjul Sanchez
• Kathryn Fanning
• Fanny Gonzalez, M.D. P.a.
• Fantastic Adult Daycare LLC

• Pediatric Emergency Medicine (Pediatrics) Physician in Miami, FL
• Providers in Miami, FL by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.