Active NPI
Manuel Fernando Antun Fernandez, M.D.
- Surgery Physician
- Hialeah, FL
National Provider Identifier
1750888988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- TRN27682
- Practice address
- 1475 W 49TH PL
Hialeah, FL 33012-3113 - Phone
- (305) 558-2500
- NPI assigned
- Apr 13, 2018
- Last updated
- Apr 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | FL | ||
| Surgery Physician | 208600000X | TRN27682 | FL | Primary |
Addresses
Primary practice location
1475 W 49TH PL
Hialeah, FL 33012-3113
Mailing address
1475 W 49TH PL
Hialeah, FL 33012-3113
Phone (305) 558-2500
Other practice location 1
1611 NW 12th Avenue ET 2169
Miami, FL 33101
Phone (305) 585-1280
Other practice location 2
Cuesta Hermosa 3 calle A #12
Santo Domingo, Arroyo Hondo xxxxx
DO
Phone (305) 985-9737
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN27682 | FL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1750888988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1475 W 49TH PL",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330123113",
"telephone_number": "305-558-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 W 49TH PL",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330123113",
"telephone_number": "305-558-2500"
}
],
"practiceLocations": [
{
"address_1": "1611 NW 12th Avenue ET 2169",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "33101",
"country_code": "US",
"telephone_number": "305-585-1280",
"fax_number": "305-585-6043",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Cuesta Hermosa 3 calle A #12",
"address_purpose": "LOCATION",
"city": "Santo Domingo",
"state": "Arroyo Hondo",
"postal_code": "xxxxx",
"country_code": "DO",
"telephone_number": "305-985-9737",
"country_name": "Dominican Republic",
"address_type": "FGN"
}
],
"basic": {
"last_name": "ANTUN FERNANDEZ",
"first_name": "MANUEL",
"middle_name": "FERNANDO",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-13",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "TRN27682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.