Individual provider Active NPI

Carlos Mario Verdeza, M.D

  • Obstetrics & Gynecology Physician
  • Miami, FL
National Provider Identifier
1376625681
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME 97208 Issued in FL
Practice address
13780 SW 26TH St
Suite 203
Miami, FL 33175-6302
Phone
(305) 553-8033
Fax
(305) 553-8013
NPI assigned
Oct 19, 2006
Last updated
Sep 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME 97208 FL Primary
General Practice Physician 208D00000X ME97208 FL

Addresses

Primary practice location

13780 SW 26TH St
Suite 203
Miami, FL 33175-6302

Mailing address

13780 SW 26TH St
Suite 203
Miami, FL 33175-6302
Phone (305) 553-8033

Other identifiers 1

IdentifierTypeStateIssuer
ME 97208OtherFLUNRESTRICTED MEDICAL LICE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 97208FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
G-Nouva LLC Obstetrics & Gynecology Current Accepting new patients

Locations

2475 NW 95th Ave
Unit 2
Doral, FL 33172
Phone (786) 453-2785

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1376625681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13780 SW 26TH ST",
            "address_2": "SUITE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756302",
            "telephone_number": "305-553-8033",
            "fax_number": "305-553-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13780 SW 26TH ST",
            "address_2": "SUITE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756302",
            "telephone_number": "305-553-8033",
            "fax_number": "305-553-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDEZA",
        "first_name": "CARLOS",
        "middle_name": "MARIO",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME 97208",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME97208",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNRESTRICTED MEDICAL LICE",
            "identifier": "ME 97208",
            "state": "FL"
        }
    ],
    "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 Sep 19, 2008; 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.