Active NPI
Idania Villalobos, MEDICAL ASST.
- Medical Physician Assistant
- Hialeah Gardens, FL
National Provider Identifier
1316210925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 206309
- Practice address
- 9160 NW 122ND St
Hialeah Gardens, FL 33018-1730 - Phone
- (305) 828-7870
- NPI assigned
- Feb 13, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 206309 | MA | Primary |
Addresses
Primary practice location
9160 NW 122ND St
Hialeah Gardens, FL 33018-1730
Mailing address
7125 NW 186TH St Apt B501
Hialeah, FL 33015-8340
Phone (786) 368-3213
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 206309 | MA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329091200000",
"number": "1316210925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7125 NW 186TH ST APT B501",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330158340",
"telephone_number": "786-368-3213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9160 NW 122ND ST",
"city": "HIALEAH GARDENS",
"state": "FL",
"postal_code": "330181730",
"telephone_number": "305-828-7870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLALOBOS",
"first_name": "IDANIA",
"credential": "MEDICAL ASST.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-13",
"last_updated": "2012-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MA",
"license": "206309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.