DR. JACOBO DUHARTE GANFONG MD
NPI 1295502417
General Practice in Miami, FL

Active since December 07, 2023PECOS Enrolled
1600 NE MIAMI GARDENS DR, MIAMI, FL 33179(786) 248-5374 Get Directions Write a Review

NPPES record last updated: February 5, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 5, 2025, Dec 7, 2023 (2 updates tracked since 2023).

About Dr. Jacobo Duharte Ganfong Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACOBO DUHARTE GANFONG MD (NPI 1295502417) is an individual general practice provider in Miami, Florida, licensed in Florida (ACN1689) and active in the NPI registry since December 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295502417
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. JACOBO DUHARTE GANFONGCredential: MD
Location Address1600 NE MIAMI GARDENS DRMiami, FL 33179-4900
Mailing Address1422 Nw 7th StMiami, FL 33125-3700 · (305) 631-8080
Sole ProprietorNo
Enumeration DateDecember 7, 2023
Last NPPES UpdateFebruary 5, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2025
NPI 1295502417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License Licensed in FL · ACN1689
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

1600 NE MIAMI GARDENS DR, Miami, FL 33179

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Jacobo Duharte Ganfong Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Massage Therapist
1600 NE MIAMI GARDENS DR
MIAMI, FL 33179
Internal Medicine (Geriatric Medicine)
1600 NE MIAMI GARDENS DR
MIAMI, FL 33179
Nurse Practitioner (Family)
1600 NE MIAMI GARDENS DR
MIAMI, FL 33179
Nurse Practitioner (Family)
1600 NE MIAMI GARDENS DR
MIAMI, FL 33179
Nurse Practitioner (Family)
1600 NE MIAMI GARDENS DR
MIAMI, FL 33179

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295502417, enumerated as an "individual" on December 07, 2023.

The provider is located at 1600 NE MIAMI GARDENS DR MIAMI, FL 33179 and the phone number is (786) 248-5374.

General Practice with taxonomy code 208D00000X.