Individual provider Active NPI

Michael John Vazquez, APRN

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1417548884
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11011300 Issued in FL
Practice address
8692 SW 161St Ave
Miami, FL 33193-5401
Phone
(786) 514-3891
NPI assigned
Jan 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11011300 FL Primary

Addresses

Primary practice location

8692 SW 161St Ave
Miami, FL 33193-5401

Mailing address

8692 SW 161St Ave
Miami, FL 33193-5401
Phone (786) 514-3891

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210910000761 FL Practitioner - Nurse Practitioner 1052717469 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11011300FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orange Care Physician Partners of Florida, LLC CurrentSince Jun 26, 2021 Accepting new patients

Locations

11011 Sheridan St
Ste 302
Hollywood, FL 33026
Phone (954) 437-1500

14750 NW 77th Ct
Ste 308
Miami Lakes, FL 33016
Phone (786) 363-8500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1417548884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8692 SW 161ST AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331935401",
            "telephone_number": "786-514-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8692 SW 161ST AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331935401",
            "telephone_number": "786-514-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11011300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.