Organization Active NPI

Carlos E Vaca MD PA

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1396050985
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0067188 Issued in FL
Legal business name
CARLOS E VACA MD PA
Practice address
8260 W Flagler St Ste 2H
Miami, FL 33144-2069
Phone
(305) 229-0551
Fax
(305) 229-1823
NPI assigned
Aug 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Authorized official

Name
Carlos E. Vaca, MDNPI 1154437028
Title
President
Phone
(305) 229-0551

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0067188 FL Primary

Addresses

Primary practice location

8260 W Flagler St Ste 2H
Miami, FL 33144-2069

Mailing address

8260 W Flagler St Ste 2H
Miami, FL 33144-2069
Phone (305) 229-0551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110624000427 FL Part B Supplier - Clinic/Group Practice 4082892930 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

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": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1396050985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8260 W FLAGLER ST STE 2H",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442069",
            "telephone_number": "305-229-0551",
            "fax_number": "305-229-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 W FLAGLER ST STE 2H",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442069",
            "telephone_number": "305-229-0551",
            "fax_number": "305-229-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS E VACA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-09",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "VACA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-229-0551",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0067188",
            "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 Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.