Individual provider Active NPI

Roberto A. Fernandez, MD

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1720101900
Registry record updated Sep 29, 2015
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 Jul 19, 2018.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN 259 Issued in FL
Practice address
2885Sw3Rd Ave 300-400
Miami, FL 33129-2324
Phone
(786) 717-7509
Fax
(786) 717-7529
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16642 PR
General Practice Physician 208D00000X ACN 259 FL Primary

Addresses

Primary practice location

2885Sw3Rd Ave 300-400
Miami, FL 33129-2324

Mailing address

2885Sw3Rd Ave 300-400
Miami, FL 33129-2324
Phone (786) 717-7509

Other identifiers 2

IdentifierTypeStateIssuer
ACN 259OtherFLMEDICAL LICENSE
16642OtherPRMEDICAL DOCTOR

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. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN 259FLMDGeneral Practice Physician
16642PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician'S Care Partners, Inc. General Practice PastSince Apr 30, 2003 Accepting new patients
Latin Foundation for Health, Inc. PastSince May 3, 2011 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1720101900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885SW3RD AVE 300-400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331292324",
            "telephone_number": "786-717-7509",
            "fax_number": "786-717-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2885SW3RD AVE 300-400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331292324",
            "telephone_number": "786-717-7509",
            "fax_number": "786-717-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ROBERTO",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16642",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN 259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ACN 259",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL DOCTOR",
            "identifier": "16642",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.