Active NPI
Luis Manuel Perez Cordova
- Surgical Assistant
- Hialeah, FL
National Provider Identifier
1023479987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 15-736
- Practice address
- 2780 W 62 St
Apt. 106
Hialeah, FL 33016 - Phone
- (305) 903-2576
- NPI assigned
- Mar 18, 2016
- Last updated
- Mar 18, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 15-736 | FL | Primary |
Addresses
Primary practice location
2780 W 62 St
Apt. 106
Hialeah, FL 33016
Mailing address
2780 W 62 St
Apt. 106
Hialeah, FL 33016
Phone (305) 903-2576
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 |
|---|---|---|---|
| 15-736 | FL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458259200000",
"number": "1023479987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2780 W 62 ST",
"address_2": "APT. 106",
"city": "HIALEAH",
"state": "FL",
"postal_code": "33016",
"telephone_number": "305-903-2576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2780 W 62 ST",
"address_2": "APT. 106",
"city": "HIALEAH",
"state": "FL",
"postal_code": "33016",
"telephone_number": "305-903-2576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ CORDOVA",
"first_name": "LUIS",
"middle_name": "MANUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-18",
"last_updated": "2016-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "FL",
"license": "15-736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.