FLORIDA INTERNATIONAL UNIVERSITY BOARD OF TRUSTEES – Family Medicine Physician, NPI 1598070849
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for FLORIDA INTERNATIONAL UNIVERSITY BOARD OF TRUSTEES
1600 S Andrews Ave Ste 1090
Ft Lauderdale, FL 333162510
Phone: (954) 523-2727
Fax: (954) 523-8814
Type: Location
11200 SW 8TH STREET
AHC 2 693
MIAMI, FL 33199
Phone: (305) 348-3627
Fax: (305) 348-4261
Type: Mailing
800 SW 108TH AVE STE 100
MIAMI, FL 331742555
Phone: (305) 348-3627
Fax: (305) 348-4261
Type: Location
11200 SW 8th St # 2693
Miami, FL 331990001
Phone: (305) 348-3627
Fax: (305) 348-4261
Type: Location
1611 NW 12th Ave
Miami, FL 331361005
Phone: (305) 348-3726
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-06-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-04-30 (770 days ago).
Enrollment records
1
Earliest due date
2024-04-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20120621000541 | O | Clinic/Group Practice | FL | 2024-04-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33316)
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