Individual provider Active NPI

Maria Auxiliadora Granados, M.D

  • Pediatrics Physician
  • Doral, FL
National Provider Identifier
1952437535
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 94633 Issued in FL
Practice address
9615 NW 41St St
Doral, FL 33178-2973
Phone
(305) 599-8022
Fax
(305) 599-8023
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 94633 FL Primary

Addresses

Primary practice location

9615 NW 41St St
Doral, FL 33178-2973

Mailing address

9615 NW 41St St
Doral, FL 33178-2973
Phone (305) 599-8022

Other identifiers 1

IdentifierTypeStateIssuer
274336100MedicaidFL

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 94633FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Kidz Pediatrics Inc Pediatrics Current Accepting new patients
Privia Medical Group Florida, LLC Past Accepting new patients

Locations

4005 NW 114th Ave
Unit 10
Doral, FL 33178

9615 NW 41st St
Doral, FL 33178
Phone (305) 599-8022

Interoperability endpoints

  • Direct secure messaging: maria.granados.1@8042.direct.athenahealth.com

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1952437535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 NW 41ST ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782973",
            "telephone_number": "305-599-8022",
            "fax_number": "305-599-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 NW 41ST ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782973",
            "telephone_number": "305-599-8022",
            "fax_number": "305-599-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "MARIA",
        "middle_name": "AUXILIADORA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 94633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274336100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.