Active NPI
Laura Isis Fernandez-Ortiz, M.D.
- Pediatrics Physician
- Miami Shores, FL
National Provider Identifier
1760432355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME82129
- Practice address
- 9715 NE 2ND Ave
Miami Shores, FL 33138-2310 - Phone
- (305) 757-8040
- Fax
- (305) 757-8011
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME82129 | FL | Primary |
Addresses
Primary practice location
9715 NE 2ND Ave
Miami Shores, FL 33138-2310
Mailing address
9715 NE 2ND Ave
Miami Shores, FL 33138-2310
Phone (305) 757-8040
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 205780617 | Other | GREAT WEST | |
| 305423 | Other | FL | AVMED |
| 205780617 | Other | TRICARE | |
| 205780617 | Other | VISTA | |
| 3434187 | Other | CIGNA | |
| 9344211 | Other | PHCS | |
| 38940 | Other | NHP | |
| 205780617 | Other | BEECH STREET | |
| 205780617 | Other | FIRST HEALTH | |
| 46690 | Other | BCBS | |
| 000170492 | Other | HUMANA | |
| 2625476 | Other | AETNA | |
| 205780617 | Other | MAJOR LEAGUE BASEBALL | |
| 10716 | Other | DIMENSION | |
| 219688703 | Other | UNITED | |
| P3202324 | Other | OXFORD |
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 |
|---|---|---|---|
| ME82129 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitalmd Group Holding LLC | Pediatrics | Past | Accepting new patients |
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": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301356800000",
"number": "1760432355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9715 NE 2ND AVE",
"city": "MIAMI SHORES",
"state": "FL",
"postal_code": "331382310",
"telephone_number": "305-757-8040",
"fax_number": "305-757-8011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9715 NE 2ND AVE",
"city": "MIAMI SHORES",
"state": "FL",
"postal_code": "331382310",
"telephone_number": "305-757-8040",
"fax_number": "305-757-8011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ-ORTIZ",
"first_name": "LAURA",
"middle_name": "ISIS",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2011-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME82129",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST",
"identifier": "205780617",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "305423",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "205780617",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VISTA",
"identifier": "205780617",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3434187",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9344211",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "38940",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEECH STREET",
"identifier": "205780617",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "205780617",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "46690",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "000170492",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2625476",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAJOR LEAGUE BASEBALL",
"identifier": "205780617",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DIMENSION",
"identifier": "10716",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED",
"identifier": "219688703",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P3202324",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami Shores, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.