Active NPI
Jairo Estrada
- Health Maintenance Organization
- Tarpon Springs, FL
National Provider Identifier
1013315126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- PTA22596
- Practice address
- 1137 Lancer LN
Tarpon Springs, FL 34689-8034 - Phone
- (727) 657-5194
- NPI assigned
- Dec 6, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | PTA22596 | FL | Primary |
Addresses
Primary practice location
1137 Lancer LN
Tarpon Springs, FL 34689-8034
Mailing address
1137 Lancer LN
Tarpon Springs, FL 34689-8034
Phone (727) 657-5194
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA22596 | FL | MD | Health Maintenance Organization |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417824000000",
"number": "1013315126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1137 LANCER LN",
"city": "TARPON SPRINGS",
"state": "FL",
"postal_code": "346898034",
"telephone_number": "727-657-5194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1137 LANCER LN",
"city": "TARPON SPRINGS",
"state": "FL",
"postal_code": "346898034",
"telephone_number": "727-657-5194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "JAIRO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-06",
"last_updated": "2014-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": "FL",
"license": "PTA22596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tarpon Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.