Individual provider Active NPI

Priscila Magdalena Fiallo, MD

  • Student in an Organized Health Care Education/Training Program
  • Wellington, FL
National Provider Identifier
1831818269
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
10101 Forest Hill Blvd
Wellington, FL 33414-6103
Phone
(561) 472-2583
NPI assigned
Aug 29, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

10101 Forest Hill Blvd
Wellington, FL 33414-6103

Mailing address

10101 Forest Hill Blvd
Wellington, FL 33414-6103
Phone (561) 472-2583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240625000483 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2769925270
I20260219001960 GA Order and Referring Only - Infectious DiseasePractitioner - Infectious Disease 2769925270

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": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1831818269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146103",
            "telephone_number": "561-472-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146103",
            "telephone_number": "561-472-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIALLO",
        "first_name": "PRISCILA",
        "middle_name": "MAGDALENA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.