Organization Active NPI

Walter R. Mullin, M.D, P.a

  • Plastic Surgery Physician
  • Miami, FL
National Provider Identifier
1053668558
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
WALTER R. MULLIN, M.D, P.A
Practice address
9155 S. Dadeland Blvd
Suite 1404
Miami, FL 33156-2739
Phone
(305) 325-1441
Fax
(305) 670-0770
NPI assigned
Aug 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Authorized official

Name
Dr. Walter R. Mullin, M.D.
Title
President/Owner
Phone
(305) 325-1441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

9155 S. Dadeland Blvd
Suite 1404
Miami, FL 33156-2739

Mailing address

9155 S Dadeland Blvd
Suite 1404
Miami, FL 33156-2737
Phone (305) 325-1441

Other identifiers 1

IdentifierTypeStateIssuer
ME16284OtherFLSTATE LICENSE #

National Provider Directory

National Provider Directory

Locations

9155 S Dadeland Blvd
Ste 1404
Miami, FL 33156
Phone (305) 663-1552

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1053668558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 S DADELAND BLVD",
            "address_2": "SUITE 1404",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562737",
            "telephone_number": "305-325-1441",
            "fax_number": "305-670-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 S. DADELAND BLVD",
            "address_2": "SUITE 1404",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562739",
            "telephone_number": "305-325-1441",
            "fax_number": "305-670-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER R. MULLIN, M.D, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "MULLIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "305-325-1441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "ME16284",
            "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 Jan 18, 2013; 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.