Individual provider Active NPI

Enrique J Viciana, MD

  • Specialist
  • Miami, FL
National Provider Identifier
1265495956
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0057841 Issued in FL
Practice address
9155 S Dadeland Blvd
Suite 1404
Miami, FL 33156-2737
Phone
(305) 663-9933
Fax
(305) 671-2390
NPI assigned
Apr 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Specialist 174400000X 0057841 FL Primary

Addresses

Primary practice location

9155 S Dadeland Blvd
Suite 1404
Miami, FL 33156-2737

Mailing address

9155 S Dadeland Blvd
Suite 1404
Miami, FL 33156-2737
Phone (305) 663-9933

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
0057841FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265495956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9155 S DADELAND BLVD",
            "address_2": "SUITE 1404",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562737",
            "telephone_number": "305-663-9933",
            "fax_number": "305-671-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 S DADELAND BLVD",
            "address_2": "SUITE 1404",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562737",
            "telephone_number": "305-663-9933",
            "fax_number": "305-671-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICIANA",
        "first_name": "ENRIQUE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "0057841",
            "primary": true
        }
    ],
    "identifiers": [],
    "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.