Organization Active NPI

Hugo Diez Jr MD PA

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1821208117
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0059913 Issued in FL
Legal business name
HUGO DIEZ JR MD PA
Practice address
11880 SW 40TH St
Suite 216
Miami, FL 33175-3584
Phone
(305) 552-5792
Fax
(305) 552-6119
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Authorized official

Name
Dr. Hugo Diez Jr Jr., MD
Title
Physician/President
Phone
(305) 552-5792

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0059913 FL Primary

Addresses

Primary practice location

11880 SW 40TH St
Suite 216
Miami, FL 33175-3584

Mailing address

11880 SW 40TH St
Suite 216
Miami, FL 33175-3584
Phone (305) 552-5792

Other identifiers 1

IdentifierTypeStateIssuer
053950300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080319000124 FL Part B Supplier - Clinic/Group Practice 2264518141 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

11880 SW 40th St
Ste 218
Miami, FL 33175
Phone (305) 229-9899

11880 SW 40th St
Ste 216
Miami, FL 33175
Phone (305) 223-2930

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1821208117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11880 SW 40TH ST",
            "address_2": "SUITE 216",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753584",
            "telephone_number": "305-552-5792",
            "fax_number": "305-552-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11880 SW 40TH ST",
            "address_2": "SUITE 216",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753584",
            "telephone_number": "305-552-5792",
            "fax_number": "305-552-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUGO DIEZ JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "DIEZ JR",
        "authorized_official_first_name": "HUGO",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "305-552-5792",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0059913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053950300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.