| Gustavo Miguel Banti, MD | |
| 2020 W 64th St, Hialeah, FL 33016-2607 | |
| (305) 642-5366 | |
| (305) 644-6407 | 
| Full Name | Gustavo Miguel Banti | 
|---|---|
| Gender | Male | 
| Speciality | Urology | 
| Location | 2020 W 64th St, Hialeah, Florida | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1710987904 | NPI | - | NPPES | 
| 776955 | Medicaid | AZ | |
| 4500628 | Other | IL | BCBS | 
| 036063412 | Medicaid | IL | |
| P01137572 | Other | AZ | RAILROAD MCR | 
| 4016817 | Other | AZ | AETNA | 
| 328075 | Other | AZ | UNIVERSAL HEALTHCARE | 
| 2136778 | Other | AZ | CIGNA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208800000X | Urology | ME112201 (Florida) | Primary | 
| Entity Name | Leon Medical Centers Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1376579839 PECOS PAC ID: 9537066618 Enrollment ID: O20031217000140 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Gustavo Miguel Banti, MD 8600 Nw 41st St, Doral, FL 33166-6202 Ph: (305) 642-5366 | Gustavo Miguel Banti, MD 2020 W 64th St, Hialeah, FL 33016-2607 Ph: (305) 642-5366 | 
| Ghassan T Hamady, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 7150 W 20th Ave, Suite 406, Hialeah, FL 33016 Phone: 305-820-1050 Fax: 305-820-1559 | |
| Alejandra Perez, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 445 E 25th St, Hialeah, FL 33013 Phone: 305-615-7952 | |
| Dr. Ariel Moises Kaufman, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2140 W 68th St, Suite 200, Hialeah, FL 33016 Phone: 305-822-7227 Fax: 305-749-8160 | |
| Andres Perez Roman, MD Urology Medicare: Medicare Enrolled Practice Location: 2140 W 68th St Ste 200, Hialeah, FL 33016 Phone: 305-822-7227 | |
| Dayron Rodriguez, MD, MPH Urology Medicare: Accepting Medicare Assignments Practice Location: 2140 W 68th St Ste 200, Hialeah, FL 33016 Phone: 305-203-0808 | |
| Dr. Fernando J Bianco, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2140 W 68th St, Suite 200, Hialeah, FL 33016 Phone: 305-822-7227 Fax: 305-827-6333 |