Organization Active NPI

Carlos a Conrado M D P a

  • Internal Medicine Physician
  • Homestead, FL
National Provider Identifier
1912023631
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0061233 Issued in FL
Legal business name
CARLOS A CONRADO M D P A
Practice address
151 NW 11TH St
Suite E102
Homestead, FL 33030-4360
Phone
(305) 248-4877
Fax
(305) 245-1576
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Authorized official

Name
Dr. Carlos A Conrado, M.D.,
Title
Owner
Phone
(305) 248-4877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 0061233 FL Primary

Addresses

Primary practice location

151 NW 11TH St
Suite E102
Homestead, FL 33030-4360

Mailing address

151 NW 11TH St
Suite E102
Homestead, FL 33030-4360
Phone (305) 248-4877

Other identifiers 2

IdentifierTypeStateIssuer
267644300MedicaidFL
18453OtherFLBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1912023631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 NW 11TH ST",
            "address_2": "SUITE E102",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304360",
            "telephone_number": "305-248-4877",
            "fax_number": "305-245-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 NW 11TH ST",
            "address_2": "SUITE E102",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304360",
            "telephone_number": "305-248-4877",
            "fax_number": "305-245-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS A CONRADO M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "CONRADO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-248-4877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "0061233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267644300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "18453",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.