Organization Active NPI

Eugenio Moises Guevara MD PA

  • Neurology Physician
  • Hialeah, FL
National Provider Identifier
1790043420
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
EUGENIO MOISES GUEVARA MD PA
Practice address
777 E 25TH St Ste 319
Hialeah, FL 33013-3849
Phone
(305) 693-8585
Fax
(305) 693-8595
NPI assigned
May 1, 2012
Last updated
Apr 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Authorized official

Name
Eugenio Moises Guevara, M.D.NPI 1033305701
Title
President
Phone
(305) 693-8585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

777 E 25TH St Ste 319
Hialeah, FL 33013-3849

Mailing address

777 E 25TH St Ste 319
Hialeah, FL 33013-3849
Phone (305) 693-8585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120515000064 FL Part B Supplier - Clinic/Group Practice 5294998092 Receives reassigned benefits from 3 practitioners
Practice locations: Hialeah, FL; Miami, FL

National Provider Directory

National Provider Directory
Tax ID family
Eugenio Moises Guevara2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

777 E 25th St
Ste 308
Hialeah, FL 33013
Phone (305) 693-8585

777 E 25th St
Ste 319
Hialeah, FL 33013
Phone (305) 447-6688

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555891200000",
    "number": "1790043420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 319",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133849",
            "telephone_number": "305-693-8585",
            "fax_number": "305-693-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 319",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133849",
            "telephone_number": "305-693-8585",
            "fax_number": "305-693-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENIO MOISES GUEVARA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2019-04-22",
        "status": "A",
        "authorized_official_last_name": "GUEVARA",
        "authorized_official_first_name": "EUGENIO",
        "authorized_official_middle_name": "MOISES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-693-8585",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.