Individual provider Active NPI

Kenwish Kenay Espinosa Aquino, SA-C

  • Surgical Assistant
  • Pembroke Pines, FL
National Provider Identifier
1114733862
Registry record updated Dec 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
19-537 Issued in IL
Practice address
18433 NW 20TH St
Pembroke Pines, FL 33029-3803
Phone
(786) 969-1111
NPI assigned
Dec 7, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2024

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 19-537 IL Primary

Addresses

Primary practice location

18433 NW 20TH St
Pembroke Pines, FL 33029-3803

Mailing address

18433 NW 20TH St
Pembroke Pines, FL 33029-3803
Phone (786) 969-1111

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
19-537ILMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1733529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733529600000",
    "number": "1114733862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18433 NW 20TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293803",
            "telephone_number": "786-969-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18433 NW 20TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293803",
            "telephone_number": "786-969-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOSA AQUINO",
        "first_name": "KENWISH",
        "middle_name": "KENAY",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-07",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "19-537",
            "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 Dec 7, 2024; 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.