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

Q: What is Jacobo Duharte Ganfong's NPI number?

The NPI number for Jacobo Duharte Ganfong is 1295502417. It was assigned to this individual provider in the NPPES registry on December 7, 2023.

Q: What is Jacobo Duharte Ganfong's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

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: August 16, 2026.

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

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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

Phone(786) 248-5374

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

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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.

VIVIAN REVILLA RODRIGUEZ FNP

Nurse Practitioner (Family)