Individual provider Active NPI

Michael P Pacin, MD

  • Allergy & Immunology Physician
  • Palmetto Bay, FL
National Provider Identifier
1003879073
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
ME19305 Issued in FL
Practice address
14411 S Dixie Hwy Ste 223
Palmetto Bay, FL 33176-7900
Phone
(305) 255-4868
Fax
(305) 255-4922
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X ME19305 FL Primary

Addresses

Primary practice location

14411 S Dixie Hwy Ste 223
Palmetto Bay, FL 33176-7900

Mailing address

11880 SW 40TH St
Suite 304
Miami, FL 33175-3584
Phone (305) 223-8808

Other practice location 1

9035 Sunset Dr
Suite 202
Miami, FL 33173-3441
Phone (305) 223-8808 ext. 404

Other identifiers 2

IdentifierTypeStateIssuer
71789ZOtherFLMEDICARE
054370500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME19305FLMDAllergy & Immunology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003879073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11880 SW 40TH ST",
            "address_2": "SUITE 304",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753584",
            "telephone_number": "305-223-8808",
            "fax_number": "305-223-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14411 S DIXIE HWY STE 223",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331767900",
            "telephone_number": "305-255-4868",
            "fax_number": "305-255-4922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9035 Sunset Dr",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331733441",
            "country_code": "US",
            "telephone_number": "305-223-8808 x404",
            "fax_number": "305-223-8974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACIN",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME19305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "71789Z",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054370500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.