Individual provider Active NPI

Jose Alejandro Barrera Ruiz, SA-C

  • Surgical Assistant
  • Pembroke Pines, FL
National Provider Identifier
1073070868
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
18-552 Issued in WI
Practice address
11660 SW 13TH CT
Pembroke Pines, FL 33025-4839
Phone
(602) 812-1828
NPI assigned
Feb 27, 2019
Last updated
Feb 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 18-552 WI Primary

Addresses

Primary practice location

11660 SW 13TH CT
Pembroke Pines, FL 33025-4839

Mailing address

11660 SW 13TH CT
Pembroke Pines, FL 33025-4839
Phone (602) 812-1828

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

LicenseStateTypeSpecialty
18-552WIMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1073070868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11660 SW 13TH CT",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330254839",
            "telephone_number": "602-812-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11660 SW 13TH CT",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330254839",
            "telephone_number": "602-812-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRERA RUIZ",
        "first_name": "JOSE",
        "middle_name": "ALEJANDRO",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "18-552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.

Verify at the official NPI Registry.