Individual provider Active NPI

Eriberto Garcia Peacok

  • Surgical Assistant
  • Miami, FL
National Provider Identifier
1124802772
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
23-562 Issued in FL
Practice address
2330 NW 11TH St Apt 33
Miami, FL 33125-3238
Phone
(786) 819-8736
NPI assigned
Aug 23, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 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 23-562 FL Primary

Addresses

Primary practice location

2330 NW 11TH St Apt 33
Miami, FL 33125-3238

Mailing address

2330 NW 11TH St Apt 33
Miami, FL 33125-3238
Phone (786) 819-8736

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
23-562FLMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1124802772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 NW 11TH ST APT 33",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331253238",
            "telephone_number": "786-819-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 NW 11TH ST APT 33",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331253238",
            "telephone_number": "786-819-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA PEACOK",
        "first_name": "ERIBERTO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "23-562",
            "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 Aug 23, 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.