Individual provider Active NPI

Fernando Enrique Amador Fiallos, MD

  • Internal Medicine Physician
  • Weirsdale, FL
National Provider Identifier
1861063505
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME167486 Issued in FL
Practice address
16400 S Highway 25
Weirsdale, FL 32195-2442
Phone
(352) 821-9797
NPI assigned
Jul 4, 2021
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME167486 FL Primary

Addresses

Primary practice location

16400 S Highway 25
Weirsdale, FL 32195-2442

Mailing address

16400 S Highway 25
Weirsdale, FL 32195-2442
Phone (352) 821-9797

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
I20240815002118 FL Practitioner - Internal Medicine 6002354537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weirsdale Family Health Center IncGroup PAC ID 7214822881, 12 clinicians

Practice addresses (Care Compare)

16400 S Hwy 25
Weirsdale, FL 32195-2442
Phone (352) 821-9797

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME167486FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weirsdale Family Health Center Inc Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

16400 S Highway 25
Weirsdale, FL 32195
Phone (352) 821-9797

Interoperability endpoints

  • Direct secure messaging: famadorfiallos739691@direct.shands.ufl.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1625356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1861063505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 S HIGHWAY 25",
            "city": "WEIRSDALE",
            "state": "FL",
            "postal_code": "321952442",
            "telephone_number": "352-821-9797",
            "fax_number": "352-821-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 S HIGHWAY 25",
            "city": "WEIRSDALE",
            "state": "FL",
            "postal_code": "321952442",
            "telephone_number": "352-821-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMADOR FIALLOS",
        "first_name": "FERNANDO",
        "middle_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-04",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME167486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirsdale, FL

Sources for this page

Verify at the official NPI Registry.