NPIMap

Organization Active NPI

Judith Valencia MD PA

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1255569844
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME98844 Issued in FL
Legal business name
JUDITH VALENCIA MD PA
Practice address
9804 SW 40TH St
Miami, FL 33165-3912
Phone
(305) 222-9154
Fax
(305) 222-9155
NPI assigned
Jun 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Authorized official

Name
Dr. Judith Valencia, MDNPI 1649478389
Title
President
Phone
(305) 222-9154

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X ME98844 FL
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X ME98844 FL Primary

Addresses

Primary practice location

9804 SW 40TH St
Miami, FL 33165-3912

Mailing address

9804 SW 40TH St
Miami, FL 33165-3912
Phone (305) 222-9154

Other identifiers 3

IdentifierTypeStateIssuer
23624OtherFLBLUE CROSS/ BLUE SHIELD
ME98844OtherFLFLORIDA LICENSE
279199400MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090626000107 FL Part B Supplier - Clinic/Group Practice 4688725963 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

9804 SW 40th St
Miami, FL 33165
Phone (305) 222-9154

Practitioners & affiliated clinicians

Practitioners 5

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": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1255569844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9804 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653912",
            "telephone_number": "305-222-9154",
            "fax_number": "305-222-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9804 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653912",
            "telephone_number": "305-222-9154",
            "fax_number": "305-222-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDITH VALENCIA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "VALENCIA",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-222-9154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME98844",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME98844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "23624",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "ME98844",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279199400",
            "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 Nov 4, 2022; 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.