Active NPI
Angel D Mora, CRT
- Radiography Radiologic Technologist
- Miami, FL
National Provider Identifier
1114211992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiography Radiologic Technologist
- License
- CRT 69470
- Practice address
- 12420 SW 192ND Ter
Miami, FL 33177-3800 - Phone
- (786) 389-0801
- Fax
- (786) 429-1701
- NPI assigned
- Jun 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiography Radiologic Technologist | 2471C3402X | CRT 69470 | FL | Primary |
Addresses
Primary practice location
12420 SW 192ND Ter
Miami, FL 33177-3800
Mailing address
12420 SW 192ND Ter
Miami, FL 33177-3800
Phone (786) 389-0801
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
| License | State | Type | Specialty |
|---|---|---|---|
| CRT 69470 | FL | MD | Radiography Radiologic Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palmetto Rehabilitation Services, Inc | Past | Accepting new patients | |
| M X Ray Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Radiology Clinic/Center
- Miami, FL
- NPI 1255604989
-
- Health Service Clinic/Center
- Miami, FL
- NPI 1164764411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1114211992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12420 SW 192ND TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331773800",
"telephone_number": "786-389-0801",
"fax_number": "786-429-1701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12420 SW 192ND TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331773800",
"telephone_number": "786-389-0801",
"fax_number": "786-429-1701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORA",
"first_name": "ANGEL",
"middle_name": "D",
"credential": "CRT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-08",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": "FL",
"license": "CRT 69470",
"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 Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.