Individual provider Active NPI

Fernando Antonio Dorrego, MD

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1750771556
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
148723 Issued in FL
Practice address
15516 SW 88TH St
Miami, FL 33196-1554
Phone
(305) 387-3300
NPI assigned
Jan 31, 2015
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 52620 TN
Internal Medicine Physician 207R00000X 148723 FL Primary

Addresses

Primary practice location

15516 SW 88TH St
Miami, FL 33196-1554

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Other names 1

  • Dr. Fernando Dorrego Benitez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151218000715 TN Practitioner - Internal Medicine 6901107804 Reassigns benefits to 1 organization
I20210414001830 FL Practitioner - Internal Medicine 6901107804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
148723FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Southern Tennessee LLC Current Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Sep 1, 2015 Accepting new patients
Conviva Medical Center Management LLC Internal Medicine CurrentSince Nov 6, 2022 Accepting new patients
Amg - Southern Tennessee, LLC CurrentSince Sep 1, 2015 Accepting new patients

Locations

440 W 49th St
Hialeah, FL 33012
Phone (305) 828-5000

15516 SW 88th St
Miami, FL 33196
Phone (305) 387-3300

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

300 S Main St
Estill Springs, TN 37330
Phone (931) 649-5139

1383 S College St
Winchester, TN 37398
Phone (931) 962-3500

185 Hospital Rd
Winchester, TN 37398
Phone (931) 962-4061

55 Sunrise Park
Winchester, TN 37398
Phone (931) 962-2272

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

Organizations & group practices 4

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": "1422662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1750771556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15516 SW 88TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331961554",
            "telephone_number": "305-387-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORREGO",
        "first_name": "FERNANDO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-31",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "52620",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "148723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FERNANDO",
            "last_name": "DORREGO BENITEZ",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.