Individual provider Active NPI

Julio Alejandro Nieto

  • Internal Medicine Physician
  • Doral, FL
National Provider Identifier
1740777663
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME150403 Issued in FL
Practice address
9615 NW 41St St
Doral, FL 33178-2973
Phone
(305) 635-1445
Fax
(305) 634-4522
NPI assigned
Apr 16, 2018
Last updated
Apr 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME150403 FL Primary

Addresses

Primary practice location

9615 NW 41St St
Doral, FL 33178-2973

Mailing address

9615 NW 41St St
Doral, FL 33178-2973
Phone (305) 635-1445

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180821003438 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5193074383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Primary Care of Miami, PA Current Accepting new patients
Aj Medicine Group, PA Current Accepting new patients

Locations

9615 NW 41st St
Doral, FL 33178
Phone (305) 599-8022

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1740777663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 NW 41ST ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782973",
            "telephone_number": "305-635-1445",
            "fax_number": "305-634-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 NW 41ST ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782973",
            "telephone_number": "305-635-1445",
            "fax_number": "305-634-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "JULIO",
        "middle_name": "ALEJANDRO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-16",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME150403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.