Organization Active NPI

Innovation Podiatry Aesthetic & Regenerative Medicine PLLC

  • Podiatrist
  • Miami Shores, FL
National Provider Identifier
1194297143
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
INNOVATION PODIATRY AESTHETIC & REGENERATIVE MEDICINE PLLC
Practice address
209 NE 95TH St Ste 6
Miami Shores, FL 33138-2745
Phone
(407) 668-8833
NPI assigned
Dec 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Authorized official

Name
Valeria Alfano Guerriero, DPMNPI 1497225379
Title
Podiatrist
Phone
(407) 668-8833

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

209 NE 95TH St Ste 6
Miami Shores, FL 33138-2745

Mailing address

1117 Asturia Ave
Coral Gables, FL 33134-4733
Phone (407) 668-8833

Other practice location 1

2500 SW 75th Ave
Miami, FL 33155-2805
Phone (305) 264-5252

Other practice location 2

1117 Asturia Ave
Coral Gables, FL 33134-4733
Phone (407) 668-8833

Other identifiers 1

IdentifierTypeStateIssuer
1497225379MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190820003335 FL Part B Supplier - Clinic/Group Practice 9234467812 Receives reassigned benefits from 1 practitioner
Practice locations: Coral Gables, FL

National Provider Directory

National Provider Directory

Locations

16215 State Road 50
Ste 102
Clermont, FL 34711
Phone (352) 221-9136

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1194297143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 ASTURIA AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344733",
            "telephone_number": "407-668-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 NE 95TH ST STE 6",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331382745",
            "telephone_number": "407-668-8833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 SW 75th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331552805",
            "country_code": "US",
            "telephone_number": "305-264-5252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1117 Asturia Ave",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331344733",
            "country_code": "US",
            "telephone_number": "407-668-8833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNOVATION PODIATRY AESTHETIC & REGENERATIVE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-31",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "ALFANO GUERRIERO",
        "authorized_official_first_name": "VALERIA",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "407-668-8833",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497225379",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.