Individual provider Active NPI

Adriana De la Fuente, PA-C

  • Physician Assistant
  • Coral Gables, FL
National Provider Identifier
1922571926
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111893 Issued in FL
Practice address
475 Biltmore Way Ste 109
Coral Gables, FL 33134-5724
Phone
(415) 424-4266
Fax
(415) 520-6633
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 62973 CA
Physician Assistant 363A00000X PA9111893 FL Primary

Addresses

Primary practice location

475 Biltmore Way Ste 109
Coral Gables, FL 33134-5724

Mailing address

8300 Esters Blvd Ste 900
Irving, TX 75063-2233
Phone (415) 424-4266

Other practice location 1

10775 Pioneer Trl Ste 215
Truckee, CA 96161-0234
Phone (415) 424-4266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190221001575 FL Practitioner - Physician Assistant 6709125594 Reassigns benefits to 3 organizations
I20250725004237 TX Practitioner - Physician Assistant 6709125594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Barry University School of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anywhere Clinic LLCGroup PAC ID 4183996317, 32 clinicians

Practice addresses (Care Compare)

4029 Dean Martin Dr
Las Vegas, NV 89103-4138
Phone (702) 848-2256

4546 N Federal Hwy
Fort Lauderdale, FL 33308-5204
Phone (702) 848-2256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
62973CAMDPhysician Assistant
PA9111893FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince Jul 21, 2022 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Jul 21, 2022 Accepting new patients
Anywhere Clinic PC Physician Assistant Past Accepting new patients
Telehealth Services USA PastSince Aug 11, 2024 Accepting new patients

Locations

8931 W Atlantic Blvd
Coral Springs, FL 33071
Phone (754) 225-7033

4825 SW 148th Ave
Davie, FL 33330
Phone (954) 526-7291

915 W 49th St
Hialeah, FL 33012
Phone (305) 200-1225

Organizations & group practices 6

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": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1922571926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 ESTERS BLVD STE 900",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632233",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BILTMORE WAY STE 109",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345724",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10775 Pioneer Trl Ste 215",
            "address_purpose": "LOCATION",
            "city": "Truckee",
            "state": "CA",
            "postal_code": "961610234",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA FUENTE",
        "first_name": "ADRIANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "62973",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.