NPIMap

Organization Active NPI

Valladares Medical Center, LLC

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1356045124
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
VALLADARES MEDICAL CENTER, LLC
Practice address
10651 SW 108TH Ave Apt 2B
Miami, FL 33176-8153
Phone
(786) 499-7099
NPI assigned
Mar 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Authorized official

Name
Simon Eleazar Valladares, PA-CNPI 1467854208
Title
Physician Assistant
Phone
(786) 499-7099

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

10651 SW 108TH Ave Apt 2B
Miami, FL 33176-8153

Mailing address

10651 SW 108TH Ave Apt 2B
Miami, FL 33176-8153
Phone (786) 499-7099

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1356045124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10651 SW 108TH AVE APT 2B",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331768153",
            "telephone_number": "786-499-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10651 SW 108TH AVE APT 2B",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331768153",
            "telephone_number": "786-499-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLADARES MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "VALLADARES",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "ELEAZAR",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "786-499-7099",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "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 Mar 28, 2023; 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.