Wilson Izquierdo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME112185 Issued in FL

Practice address

5810 Sheridan St
Hollywood, FL 33021-3244

Phone

(954) 251-2381

Fax

(954) 251-2365

NPI assigned

Oct 28, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Wilson Izquierdo Professional name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Medical Center International Inc

  • Family Medicine Physician
  • Hollywood, FL
  • NPI 1467041715
  Medicare reassignment Authorized official
• Wilson Izquierdo MD, Inc

  • Urgent Care Clinic/Center
  • San Bernardino, CA
  • NPI 1306106000
  NPD Authorized official
• Gospha G, Campbell MD Inc

  • Adult Medicine Physician
  • San Bernardino, CA
  • NPI 1215182803
  NPD (past)

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1396998944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213244",
            "telephone_number": "954-251-2381",
            "fax_number": "954-251-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213244",
            "telephone_number": "954-251-2381",
            "fax_number": "954-251-2365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2229 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330202040",
            "country_code": "US",
            "telephone_number": "954-251-2381",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 E Oakland Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Oakland Park",
            "state": "FL",
            "postal_code": "333342149",
            "country_code": "US",
            "telephone_number": "954-251-2381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IZQUIERDO",
        "first_name": "WILSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A117127",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17291",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME112185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILSON",
            "last_name": "IZQUIERDO",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ruslan Ivanov, MD
• Yanela Iznaga Soria
• Amanda Thalia Izquierdo
• Lorraine Dee Dalisay Izquierdo, NP
• Naylen Izquierdo
• Jessica L. Izyk, PT, DPT
• J Craig Uecker MD PA
• Israel Salvador Jacas Carvajal
• Kenya A'Leesha Alyxx Jack
• Jade Indira Jackson

• Family Medicine Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.