Individual provider Active NPI

Mauricio Vargas

  • Clinical Social Worker
  • Doral, FL
National Provider Identifier
1336508001
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW1826 Issued in FL
Practice address
8600 NW 41St St
Doral, FL 33166-6202
Phone
(305) 642-5366
NPI assigned
Feb 23, 2016
Last updated
Jan 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW1826 FL Primary

Addresses

Primary practice location

8600 NW 41St St
Doral, FL 33166-6202

Mailing address

8600 NW 41St St
Doral, FL 33166-6202
Phone (305) 642-5366

Other practice location 1

4045 Sheridan Ave
Suite 236
Miami Beach, FL 33140-3665
Phone (305) 397-8255

Other identifiers 2

IdentifierTypeStateIssuer
CMHP50204OtherCERTIFIED MENTAL HEALTH PROFESSIONAL
CAP2113OtherCERTIFIED ADDICTION PROFESSIONAL

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

LicenseStateTypeSpecialty
ISW1826FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1336508001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 NW 41ST ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666202",
            "telephone_number": "305-642-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 NW 41ST ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666202",
            "telephone_number": "305-642-5366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4045 Sheridan Ave",
            "address_2": "Suite 236",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331403665",
            "country_code": "US",
            "telephone_number": "305-397-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "MAURICIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-23",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW1826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED MENTAL HEALTH PROFESSIONAL",
            "identifier": "CMHP50204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ADDICTION PROFESSIONAL",
            "identifier": "CAP2113",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.