Individual provider Active NPI

Joaquin J Fuenmayor, MD

  • Specialist
  • Miami, FL
National Provider Identifier
1811983679
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME42923 Issued in FL
Practice address
11880 Bird Rd Ste 402
Miami, FL 33175-3575
Phone
(305) 226-0080
Fax
(305) 226-0707
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME42923 FL Primary

Addresses

Primary practice location

11880 Bird Rd Ste 402
Miami, FL 33175-3575

Mailing address

PO Box 650130
Miami, FL 33265-0130
Phone (305) 226-0080

Other identifiers 1

IdentifierTypeStateIssuer
371455100MedicaidFL

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
I20110114000759 FL Practitioner - Otolaryngology 0143419564 Practice locations: Miami, FL

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11760 S W 40TH St
Suite 557
Miami, FL 33175-8100
Phone (305) 226-0080

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1811983679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650130",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332650130",
            "telephone_number": "305-226-0080",
            "fax_number": "305-228-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11880 BIRD RD STE 402",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753575",
            "telephone_number": "305-226-0080",
            "fax_number": "305-226-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENMAYOR",
        "first_name": "JOAQUIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME42923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371455100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.