Individual provider Active NPI

Jorge Paoli-Bruno, M.D.

  • Family Medicine Physician
  • Medley, FL
National Provider Identifier
1982601159
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 110249 Issued in FL
Practice address
7911 NW 72ND Ave Ste 109B
Medley, FL 33166-2221
Phone
(305) 887-1005
Fax
(305) 887-1092
NPI assigned
Jul 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12292 PR
Family Medicine Physician 207Q00000X ME 110249 FL Primary

Addresses

Primary practice location

7911 NW 72ND Ave Ste 109B
Medley, FL 33166-2221

Mailing address

PO Box 227113
Doral, FL 33222-7113

Other practice location 1

12002 SW 128th Ct Ste 202
Miami, FL 33186-4643
Phone (786) 362-6114

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
I20120726000005 FL Practitioner - Family Practice 2466350699 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 110249FLMDFamily Medicine Physician
ME110249FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Sport Medical Corp CurrentSince Jan 18, 2013 Accepting new patients
La Esperanza Medical Centers Inc Family Medicine CurrentSince Apr 9, 2014 Accepting new patients
Healing at Hand, Inc. CurrentSince Dec 3, 2012 Accepting new patients
Health Admin SVC Inc Past Accepting new patients
Jorge Paoli-Bruno, M.D., P.a. Family Medicine Past Accepting new patients
Critical Care Medicine Services, Inc. Past Accepting new patients
Emergenciologos Para Puerto Rico,CSP Past Accepting new patients
Omy Medical Center, Corp PastSince Aug 31, 2013 Accepting new patients
Coral Diagnostic Center Inc PastSince Aug 2, 2020 Accepting new patients

Locations

7911 NW 72nd Ave
Ste 109
Medley, FL 33166
Phone (305) 887-1005

7911 NW 72nd Ave
Ste 109AB
Medley, FL 33166
Phone (305) 887-1005

7303 W Flagler St
Miami, FL 33144
Phone (305) 265-6683

6555 NW 36th St
Ste 214
Virginia Gardens, FL 33166
Phone (305) 526-8229

Organizations & group practices 9

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": "1120348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1982601159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 227113",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "332227113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7911 NW 72ND AVE STE 109B",
            "city": "MEDLEY",
            "state": "FL",
            "postal_code": "331662221",
            "telephone_number": "305-887-1005",
            "fax_number": "305-887-1092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12002 SW 128th Ct Ste 202",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331864643",
            "country_code": "US",
            "telephone_number": "786-362-6114",
            "fax_number": "786-362-6172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAOLI-BRUNO",
        "first_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-03",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "12292",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 110249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medley, FL

Sources for this page

Verify at the official NPI Registry.