DEREK PRABHARASUTH (NPI# 1164846986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164846986 |
| Entity Type | Individual |
| Full Name | DEREK PRABHARASUTH |
| Credential | MD |
| Practice Address |
11760 Sw 40th St Ste 403 Miami FL 33175-3595 |
| Practice Telephone | 3052262020 |
| Practice Fax Number | 3052262018 |
| Mailing Telephone | 3052262020 |
| Mailing Fax Number | 3052262018 |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2020-08-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | ME122730 | FL | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 74307 | GA | Allopathic & Osteopathic Physicians |
| N | 208800000X | Urology | 60 255424 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
11760 SW 40TH ST STE 403 |
| City | MIAMI |
| State | FL |
| Zip Code | 33175-3595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885965 | Kevin Bernardo Gonzalez | Behavior Technician | 11895 Sw 37 St, Miami, FL 33175 | 2020-06-11 |
| 1619509106 | Gladysbel Lorenzo | Nurse Practitioner | 11740 Sw 42st, Miami, FL 33175 | 2020-02-12 |
| 1154885200 | Vanessa Arzola Dmd Pa and Associates | Clinic/Center | 13419 Sw 56th Street, Miami, Miami, FL 33175 | 2019-01-23 |
| 1588145932 | Mailen Gonzalez | Nurse Practitioner | 12294 Sw 29 Ter, Miami, FL 33175 | 2018-08-23 |
| 1639655350 | Carolina Marie Trueba | Behavior Technician | 12825 Sw 49th Terr, Miami, FL 33175 | 2018-07-16 |
| 1033611504 | Joan Coro | Behavior Technician | 12905 Sw 42nd St Suite 219, Miami, FL 33175 | 2018-03-01 |
| 1417456864 | Ignacio Alzugaray | Nurse Practitioner | 12317 Sw 20th Ter, Miami, FL 33175 | 2018-02-12 |
| 1215436993 | Desiree Rengifo-glasgow | Nurse Practitioner | 11865 Sw 26th St Ste J2, Miami, FL 33175 | 2018-02-07 |
| 1639678691 | Behavior Professional Consultants Corp. | Community/Behavioral Health | 2460 Sw 137th Ave 242, Miami, FL 33175 | 2018-02-06 |
| 1992204291 | Humberto Lorenzo Paez | Nurse Practitioner | 4205 Sw 136th Place, Miami, FL 33175 | 2018-02-02 |
| Find all providers in zip 33175 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770952616 | Genesiscare Usa of Florida LLC | Urology | 3361 South Miami Avenue, Suite 306, Miami, FL 33133-4232 | 2015-09-22 |
| 1790152908 | Bruno Nahar Aragao De Oliveira | Urology | 1120 Nw 14th St Ste 1564b, Miami, FL 33136-2107 | 2015-08-24 |
| 1912382417 | Vivek Venkatramani | Urology | 1250 S Miami Ave Apt 1311, Miami, FL 33130-4107 | 2015-07-25 |
| 1093127631 | Jose Luis Vilaro Valderrabano | Urology | 3641 S Miami Ave Ste 170, Miami, FL 33133-4219 | 2014-06-02 |
| 1780023135 | Sanjaya Kumar Swain | Urology | 1150 Pac Clinic University of Miami Hospital, Room No 309, Miami, FL 33136 | 2013-06-19 |
| 1467716183 | Emad Ibrahim | Urology | 1095 Nw 14th Ter # R48, Rm 1-10, Miami, FL 33136-1060 | 2012-06-27 |
| 1215295639 | Ricardo Ismael Palmerola | Urology | 4220 Sw 60th Ct, Miami, FL 33155-5224 | 2012-04-24 |
| 1437425246 | Katherine A. Amin | Urology | Professional Arts Center, 1150 Nw 14th St, Suite 309, Miami, FL 33136 | 2012-03-26 |
| 1073803490 | Nicholas Joseph Hauser | Urology | 1150 Nw 14th St Ste 309, Miami, FL 33136 | 2011-04-19 |
| 1720239510 | Melvin A. Mackler, M.d. Pa | Urology | 8669 N.w 36 Street, Suite 325, Miami, FL 33166 | 2008-10-10 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.