Individual provider Active NPI

Mavis Aguilera, CHIROPRACTOR PHYS AS

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1164446084
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
CI 422 Issued in FL
Practice address
8740 SW 8TH St
Miami, FL 33174-3201
Phone
(305) 228-2772
Fax
(305) 228-2928
NPI assigned
Jul 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CI 422 FL Primary

Addresses

Primary practice location

8740 SW 8TH St
Miami, FL 33174-3201

Mailing address

8740 SW 8TH St
Miami, FL 33174-3201
Phone (305) 228-2772

Other identifiers 1

IdentifierTypeStateIssuer
CI 422OtherFLCHIROPRACTOR PHY ASSIS

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
Credentials
Associate of Science

State licenses

LicenseStateTypeSpecialty
CI 422FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Asclepius Medical Inc. PastSince Feb 17, 2003 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164446084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8740 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743201",
            "telephone_number": "305-228-2772",
            "fax_number": "305-228-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8740 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743201",
            "telephone_number": "305-228-2772",
            "fax_number": "305-228-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILERA",
        "first_name": "MAVIS",
        "name_prefix": "Mrs.",
        "credential": "CHIROPRACTOR PHYS AS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "CI 422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTOR PHY ASSIS",
            "identifier": "CI 422",
            "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 Jul 8, 2007; 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.