Active NPI
Ileana Fuentes, MD
- Pediatrics Physician
- Miami, FL
National Provider Identifier
1831276914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME75683
- Practice address
- 3601 Federal Hwy
Miami, FL 33137-3795 - Phone
- (305) 576-6611
- Fax
- (305) 576-0008
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
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 | ME75683 | FL | Primary |
Addresses
Primary practice location
3601 Federal Hwy
Miami, FL 33137-3795
Mailing address
3601 Federal Hwy
Miami, FL 33137-3795
Phone (305) 576-6611
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E1661Z | Other | FL | MEDICARE |
| 254911500 | Medicaid | FL |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME75683 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Borinquen Health Care Center, Inc. | Current | Accepting new patients |
Locations
3601 Federal Hwy
Miami, FL 33137
Interoperability endpoints
- ileana.fuentes.1@8506.direct.athenahealth.com
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.
-
- Federally Qualified Health Center (FQHC)
- Miami, FL
- NPI 1407913338
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1831276914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 FEDERAL HWY",
"city": "MIAMI",
"state": "FL",
"postal_code": "331373795",
"telephone_number": "305-576-6611",
"fax_number": "786-476-2819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 FEDERAL HWY",
"city": "MIAMI",
"state": "FL",
"postal_code": "331373795",
"telephone_number": "305-576-6611",
"fax_number": "305-576-0008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUENTES",
"first_name": "ILEANA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME75683",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "E1661Z",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "254911500",
"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 Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.