Active NPI
Tatiana Marina Tellez Antunez
- General Practice Physician
- South Miami, FL
National Provider Identifier
1720736291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- ACN1470
- Practice address
- 7301 SW 62ND St
South Miami, FL 33143-1812 - Phone
- (786) 563-2814
- NPI assigned
- Mar 14, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | ACN1470 | FL | Primary |
Addresses
Primary practice location
7301 SW 62ND St
South Miami, FL 33143-1812
Mailing address
7301 SW 62ND St
South Miami, FL 33143-1812
Phone (786) 563-2814
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
| License | State | Type | Specialty |
|---|---|---|---|
| ACN1470 | FL | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715644800000",
"number": "1720736291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7301 SW 62ND ST",
"city": "SOUTH MIAMI",
"state": "FL",
"postal_code": "331431812",
"telephone_number": "786-563-2814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7301 SW 62ND ST",
"city": "SOUTH MIAMI",
"state": "FL",
"postal_code": "331431812",
"telephone_number": "786-563-2814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLEZ ANTUNEZ",
"first_name": "TATIANA",
"middle_name": "MARINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-14",
"last_updated": "2024-05-14",
"certification_date": "2024-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ACN1470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.