Individual provider Active NPI

Brendan J Lutz, DO

  • Student in an Organized Health Care Education/Training Program
  • Miami Beach, FL
National Provider Identifier
1760011522
Registry record updated Jun 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4300 Alton Rd
Miami Beach, FL 33140-2948
Phone
(305) 674-2273
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4300 Alton Rd
Miami Beach, FL 33140-2948

Mailing address

4300 Alton Rd
Miami Beach, FL 33140-2948

Other practice location 1

University Of Tennessee 920 Madison Avenue Suite 447
Memphis, TN 38163-0001
Phone (901) 448-0230

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
I20260304002808 FL Practitioner - Obstetrics/Gynecology 0042640096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13105 SW 39TH Ave Rd
Ocala, FL 34473-5263

1614 W Ave
Apt 505
Miami Beach, FL 33139-2345

374 E Piney Rd
Dickson, TN 37055-3927

705 E 26TH St
Hialeah, FL 33013-3823

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carlos Rodriguez Ortiz MD, PA CurrentSince Jan 27, 2026 Accepting new patients

Locations

705 E 26th St
Hialeah, FL 33013
Phone (305) 835-1551

11760 SW 40th St
Ste 642
Miami, FL 33175
Phone (305) 553-6744

3683 S Miami Ave
Ste 400
Miami, FL 33133
Phone (305) 200-3878

Organizations & group practices 1

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624752000000",
    "number": "1760011522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402948",
            "telephone_number": "305-674-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University Of Tennessee 920 Madison Avenue Suite 447",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381630001",
            "country_code": "US",
            "telephone_number": "901-448-0230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "BRENDAN",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2021-06-27",
        "certification_date": "2021-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.