Individual provider Active NPI

Luis M Campillo, MD

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1922054352
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 64856 Issued in FL
Practice address
6850 Coral Way Ste 502
Miami, FL 33155-1758
Phone
(305) 456-1600
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME 64856 FL Primary

Addresses

Primary practice location

6850 Coral Way Ste 502
Miami, FL 33155-1758

Mailing address

6850 Coral Way Ste 502
Miami, FL 33155-1758
Phone (305) 456-1600

Other practice location 1

3485 W Flagler St Ste 300
Miami, FL 33135-1042
Phone (305) 456-1600

Other identifiers 1

IdentifierTypeStateIssuer
105806400MedicaidFL

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
I20040217000093 FL Practitioner - Family Practice 7113812413 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 64856FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Circle Health Inc CurrentSince Dec 3, 2023 Accepting new patients
General Rehabilitation Facility Co CurrentSince Dec 17, 2018 Accepting new patients
Professional Health Center Corp Family Medicine Past Accepting new patients
First United Medical Center Inc Past Accepting new patients
Naples Injury Center Inc Past Accepting new patients
Campillo Medical Inc Family Medicine PastSince Apr 1, 2002 Accepting new patients
Policlinico Pastorita Inc Past Accepting new patients
Zorrilla Medical Center Inc Past Accepting new patients
Naples Injury Center #2 Inc Past Accepting new patients
Personal Care Medical Center Inc Family Medicine Past Accepting new patients
Rafael Pelegrin M.D,Medical GRP, LLC Past Accepting new patients
Healing at Hand, Inc. PastSince Dec 3, 2012 Accepting new patients

Locations

600 E 25th St
Ste F
Hialeah, FL 33013
Phone (305) 691-0112

12900 SW 128th St
Ste 204B
Miami, FL 33186
Phone (786) 227-6020

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1922054352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 CORAL WAY STE 502",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551758",
            "telephone_number": "305-456-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 CORAL WAY STE 502",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551758",
            "telephone_number": "305-456-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3485 W Flagler St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331351042",
            "country_code": "US",
            "telephone_number": "305-456-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPILLO",
        "first_name": "LUIS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 64856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105806400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.