Individual provider Active NPI

Eric Raul Valladares, MD

  • Surgery Physician
  • Miami, FL
National Provider Identifier
1114990983
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD91049 Issued in FL
Practice address
2660 SW 3Rd St
Miami, FL 33135-1415
Phone
(305) 631-5355
Fax
(305) 631-5354
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD91049 FL Primary

Addresses

Primary practice location

2660 SW 3Rd St
Miami, FL 33135-1415

Mailing address

PO Box 451050
Miami, FL 33245-1050
Phone (305) 631-5355

Other identifiers 1

IdentifierTypeStateIssuer
274700600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061010000181 FL Practitioner - Colorectal Surgery (Proctology)Practitioner - General PracticePractitioner - General Surgery 4385622208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD91049FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
South Florida Surgical Services LLC Surgery Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1114990983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451050",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332451050",
            "telephone_number": "305-631-5355",
            "fax_number": "305-631-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 SW 3RD ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331351415",
            "telephone_number": "305-631-5355",
            "fax_number": "305-631-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLADARES",
        "first_name": "ERIC",
        "middle_name": "RAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "MD91049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274700600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.