Premier Florida Podiatry, PA

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PREMIER FLORIDA PODIATRY, PA

Practice address

3060 NE 190TH St Apt 202
Aventura, FL 33180

Phone

(786) 530-7250

NPI assigned

Mar 4, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Maria T Ibanez, DPMNPI 1477724201

Title

President

Phone

(786) 530-7250

Specialties & licenses 1

Addresses

Practitioners 1

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

• Maria Teresa Ibanez, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Berlin, VT
  • NPI 1477724201
  NPD Authorized official

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

{
    "created_epoch": "1520121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1235631474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 NE 190TH ST APT 202",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803132",
            "telephone_number": "786-530-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 NE 190TH ST APT 202",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "786-530-7250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19594 E Country Club Dr",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331804831",
            "country_code": "US",
            "telephone_number": "786-530-7250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER FLORIDA PODIATRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-04",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "IBANEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-530-7250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Aventura, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.