Dr. Mariano Fondevila , MD
General Practice • Miami, FL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mariano Fondevila has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Mariano Fondevila, MD was a registered General Practice practicing in Miami, FL. Throughout an active medical career spanning 16 years, Dr. Fondevila provided care at the practice location at 1300 CORAL WAY until profile deactivation on 2021-08-23.
Historical Medicare Part B clinical services included established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.
Practice Location & Contact Primary Location
1300 Coral Way
Suite 104
Miami, FL 331452934
Specialty Benchmarks & Practice Insights
Comparative analytics for General Practice in Miami, FL
Practicing in Miami, FL (2490 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Performed Procedures & Service Volume
Top Medicare Part B procedures performed by this practitioner
| HCPCS Code & Description | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
|
99214
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
|
29 | 24 | $250.00 | $115.98 |
|
99213
Established patient office or other outpatient visit, typically 15 minutes
|
16 | 13 | $115.00 | $79.35 |
Medical Specialties & State Licenses
NUCC Taxonomy Code: 208D00000X
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Dentist
Doctor of Dental Surgery
Speech-Language Pathologist
Master of Science
Dentist
Doctor of Dental Surgery
Speech-Language Pathologist
Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)
Dentist - General Practice
Speech-Language Pathologist
Speech-Language Pathologist (Certificate of Clinical Competence)
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on August 23, 2021
NPI status registered as active in NPPES database
Registered at 1300 CORAL WAY, SUITE 104, MIAMI, FL 331452934 (Tel: 3058545631)
Registered at 1300 CORAL WAY, SUITE 104, MIAMI, FL 331452934 (Tel: 3058545631)
Recorded as MARIANO FONDEVILA, M.D.
General Practice (License #ME0028435 in FL)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1300 Coral Way, Suite 104
Miami, FL 331452934
Phone: 3058545631
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