Individual provider Active NPI

Mario I Quiros, MD

  • Pediatrics Physician
  • Miami Lakes, FL
National Provider Identifier
1225027782
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME59718 Issued in FL
Practice address
16250 NW 57TH Ave
Miami Lakes, FL 33014-6711
Phone
(786) 442-2136
Fax
(305) 823-0914
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME59718 FL Primary

Addresses

Primary practice location

16250 NW 57TH Ave
Miami Lakes, FL 33014-6711

Mailing address

900 S Pine Island Rd
Suite 800
Plantation, FL 33324-3920
Phone (305) 821-8611

Other identifiers 1

IdentifierTypeStateIssuer
023688100MedicaidFL

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME59718FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittel, Levin and Jacobson, LLC Pediatrics CurrentSince Jun 12, 2022 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics PastSince Jun 12, 2022 Accepting new patients
Community Health of South Florida, Inc. Past Accepting new patients

Locations

16250 NW 57th Ave
Miami Lakes, FL 33014
Phone (786) 442-2136

900 S Pine Island Rd
Ste 800
Plantation, FL 33324
Phone (954) 967-6400

Interoperability endpoints

  • Direct secure messaging: mquiros@pa.trimed.direct-ci.com

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1225027782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD",
            "address_2": "SUITE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243920",
            "telephone_number": "305-821-8611",
            "fax_number": "305-827-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16250 NW 57TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146711",
            "telephone_number": "786-442-2136",
            "fax_number": "305-823-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIROS",
        "first_name": "MARIO",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME59718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023688100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.