Active NPI
Altagracia Recio, PHYSICIAN ASSISTANT
- Physician Assistant
- Miami, FL
National Provider Identifier
1003904699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 9101967
- Practice address
- 701 SW 27TH Ave
Miami, FL 33135-3031 - Phone
- (305) 642-3396
- Fax
- (305) 642-6622
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 9101967 | FL | Primary |
Addresses
Primary practice location
701 SW 27TH Ave
Miami, FL 33135-3031
Mailing address
701 SW 27TH Avenue
Miami, FL 33135
Phone (305) 642-3396
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 291288100 | Medicaid | FL |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9101967 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291248000000",
"number": "1003904699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 SW 27TH AVENUE",
"city": "MIAMI",
"state": "FL",
"postal_code": "33135",
"telephone_number": "305-642-3396",
"fax_number": "305-642-6622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 SW 27TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331353031",
"telephone_number": "305-642-3396",
"fax_number": "305-642-6622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RECIO",
"first_name": "ALTAGRACIA",
"name_prefix": "Ms.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2010-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA 9101967",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "291288100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.