Individual provider Active NPI

Gabriel Antonio Carreno Moya, SA-C

  • Surgical Assistant
  • Miami, FL
National Provider Identifier
1093587719
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
17-461 Issued in FL
Practice address
539 NE 82ND Ter Apt 4
Miami, FL 33138-4075
Phone
(786) 716-3798
NPI assigned
Oct 25, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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 17-461 FL Primary

Addresses

Primary practice location

539 NE 82ND Ter Apt 4
Miami, FL 33138-4075

Mailing address

539 NE 82ND Ter Apt 4
Miami, FL 33138-4075
Phone (786) 716-3798

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
17-461FLMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1093587719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 NE 82ND TER APT 4",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331384075",
            "telephone_number": "786-716-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 NE 82ND TER APT 4",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331384075",
            "telephone_number": "786-716-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRENO MOYA",
        "first_name": "GABRIEL",
        "middle_name": "ANTONIO",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "17-461",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 25, 2023; 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.