Individual provider Active NPI

Eduardo J Alarcon, MD

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1104873504
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME44378 Issued in FL
Practice address
4960 SW 72ND Ave Ste 203
Miami, FL 33155-5549
Phone
(305) 479-2393
Fax
(305) 847-3737
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME44378 FL Primary

Addresses

Primary practice location

4960 SW 72ND Ave Ste 203
Miami, FL 33155-5549

Mailing address

4960 SW 72ND Ave Ste 203
Miami, FL 33155-5549
Phone (305) 479-2393

Other identifiers 2

IdentifierTypeStateIssuer
ME44378OtherFLMEDICAL LICENSE
049797500MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME44378FLMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1104873504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE STE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555549",
            "telephone_number": "305-479-2393",
            "fax_number": "330-584-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE STE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555549",
            "telephone_number": "305-479-2393",
            "fax_number": "305-847-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALARCON",
        "first_name": "EDUARDO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME44378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME44378",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049797500",
            "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 Dec 11, 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.