Bacallao Health Services Corp

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME92076 Issued in FL

Legal business name

BACALLAO HEALTH SERVICES CORP

Practice address

2471 NW 7TH St
Miami, FL 33125-3150

Phone

(305) 541-8849

Fax

(305) 541-4658

NPI assigned

Aug 26, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jorge J Bacallao, MD

Title

President

Phone

(305) 541-8849

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Bacallao Health Services Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bacallao Health Servies,Corp

  • Ophthalmology Physician
  • North Bay Village, FL
  • NPI 1710118492
  NPD tax ID

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1083861694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2471 NW 7TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331253150",
            "telephone_number": "305-541-8849",
            "fax_number": "305-541-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2471 NW 7TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331253150",
            "telephone_number": "305-541-8849",
            "fax_number": "305-541-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACALLAO HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "BACALLAO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-541-8849",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME92076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268789500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Baca, NP
• Mauricio Jose Baca, MD
• Tabitha Baca, MD
• Yesenia De la Caridad Bacallao Amador
• Yaima Bacallao Borges
• Yudania Bacallao Mayedo
• Yasmin Bacallao Mendez
• Maria K Bacallao Ramos
• Beatriz Bacallao Ravelo
• Anthony Bacallao

• Ophthalmology Physician in Miami, FL
• Providers in Miami, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.