Individual provider Active NPI

Jorge Reyes-Cardero, SURGICAL ASSITANT

  • Specialist
  • Miami, FL
National Provider Identifier
1366861734
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
13-428 Issued in FL
Practice address
3661 S Miami Ave Ste 708
Miami, FL 33133-4214
Phone
(305) 856-1002
Fax
(305) 856-0199
NPI assigned
Apr 14, 2014
Last updated
Apr 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 13-428 FL Primary

Addresses

Primary practice location

3661 S Miami Ave Ste 708
Miami, FL 33133-4214

Mailing address

4033 NW 11TH St Apt 25
Miami, FL 33126-3600
Phone (786) 318-7097

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
13-428FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1366861734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 NW 11TH ST APT 25",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263600",
            "telephone_number": "786-318-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 S MIAMI AVE STE 708",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334214",
            "telephone_number": "305-856-1002",
            "fax_number": "305-856-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES-CARDERO",
        "first_name": "JORGE",
        "credential": "SURGICAL ASSITANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "13-428",
            "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 Apr 14, 2014; 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.