Active NPI
Daniel Rolando Fundora, CRT
- Radiologic Technologist
- Miami, FL
National Provider Identifier
1932529997
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Jan 19, 2023.
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- CRT63103
- Practice address
- 601 SW 57TH Ave Ste C
Miami, FL 33144-3974 - Phone
- (786) 308-7607
- NPI assigned
- Apr 17, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | CRT63103 | FL | Primary |
Addresses
Primary practice location
601 SW 57TH Ave Ste C
Miami, FL 33144-3974
Mailing address
28 Majorca Ave Apt 4
Coral Gables, FL 33134-4603
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRT63103 | FL | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397692800000",
"number": "1932529997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 MAJORCA AVE APT 4",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331344603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 SW 57TH AVE STE C",
"city": "MIAMI",
"state": "FL",
"postal_code": "331443974",
"telephone_number": "786-308-7607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNDORA",
"first_name": "DANIEL",
"middle_name": "ROLANDO",
"credential": "CRT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-17",
"last_updated": "2014-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "FL",
"license": "CRT63103",
"primary": true
}
],
"identifiers": [],
"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 Apr 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.