Organization Active NPI

Digestive Medicine Histology Lab, LLC

  • Clinical Medical Laboratory
  • Hialeah, FL
National Provider Identifier
1932423449
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
DIGESTIVE MEDICINE HISTOLOGY LAB, LLC
Practice address
2140 W 68TH St
Suite 103
Hialeah, FL 33016-1815
Phone
(305) 822-4107
Fax
(305) 822-5086
NPI assigned
Mar 26, 2010
Last updated
Jan 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Authorized official

Name
Dr. Francisco R Maderal, MDNPI 1861470551
Title
Physician
Phone
(305) 822-4107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2140 W 68TH St
Suite 103
Hialeah, FL 33016-1815

Mailing address

2140 W 68TH St
Suite 305
Hialeah, FL 33016-1815
Phone (305) 822-4107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101208001087 FL Part B Supplier - Clinic/Group Practice 8628265238 Receives reassigned benefits from 3 practitioners
Practice locations: Hialeah, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2010126Digestive Medicine Histology Lab LLC2140 W 68TH St Ste 103, Hialeah, FL 33016AccreditationSep 6, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2140 W 68th St
Ste 103
Hialeah, FL 33016
Phone (305) 822-4107

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1932423449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 W 68TH ST",
            "address_2": "SUITE 305",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161815",
            "telephone_number": "305-822-4107",
            "fax_number": "305-822-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 W 68TH ST",
            "address_2": "SUITE 103",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161815",
            "telephone_number": "305-822-4107",
            "fax_number": "305-822-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE MEDICINE HISTOLOGY LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-26",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "MADERAL",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "305-822-4107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.