Individual provider Active NPI

Marco A Amendola, MD

  • Body Imaging Physician
  • Miami, FL
National Provider Identifier
1922031095
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
ME58412 Issued in FL
Practice address
1611 NW 12TH Ave
Box 016960 (M851)
Miami, FL 33136-1005
Phone
(305) 243-6358
Fax
(305) 243-8470
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X ME58412 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Box 016960 (M851)
Miami, FL 33136-1005

Mailing address

5995 SW 71St St
South Miami, FL 33143-3531
Phone (305) 669-6833

Other identifiers 1

IdentifierTypeStateIssuer
0616028-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
977FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Beatriz E Amendola MD PA CurrentSince Dec 12, 2021 Accepting new patients
University of Miami Past Accepting new patients

Locations

5995 SW 71st St
#1A
South Miami, FL 33143
Phone (305) 598-0811

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1922031095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 SW 71ST ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433531",
            "telephone_number": "305-669-6833",
            "fax_number": "305-666-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "BOX 016960 (M851)",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-6358",
            "fax_number": "305-243-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMENDOLA",
        "first_name": "MARCO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "FL",
            "license": "ME58412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0616028-00",
            "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 8, 2018; 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.