Active NPI
Walther Martin Piedra
- Driver
- Melbourne, FL
National Provider Identifier
1013473198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- P362893672490
- Practice address
- 5768 Tamarac Dr
Melbourne, FL 32940-8058 - Phone
- (321) 210-6175
- NPI assigned
- Feb 14, 2019
- 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 |
|---|---|---|---|---|
| Driver | 172A00000X | P362893672490 | FL | Primary |
Addresses
Primary practice location
5768 Tamarac Dr
Melbourne, FL 32940-8058
Mailing address
5768 Tamarac Dr
Melbourne, FL 32940-8058
Phone (321) 210-6175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P362893672490 | Other | FL | DRIVER LINCENSE |
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 |
|---|---|---|---|
| P362893672490 | FL | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550102400000",
"number": "1013473198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5768 TAMARAC DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329408058",
"telephone_number": "321-210-6175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5768 TAMARAC DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329408058",
"telephone_number": "321-210-6175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIEDRA",
"first_name": "WALTHER",
"middle_name": "MARTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-14",
"last_updated": "2019-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "FL",
"license": "P362893672490",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LINCENSE",
"identifier": "P362893672490",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.