Individual provider Active NPI

Juan Augusto Valladares, M.D.

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1427067149
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41931 Issued in FL
Practice address
3400 SW 107TH Ave
Miami, FL 33165-3633
Phone
(305) 559-7330
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41931 FL Primary

Addresses

Primary practice location

3400 SW 107TH Ave
Miami, FL 33165-3633

Mailing address

3400 SW 107TH Ave
Miami, FL 33165-3633
Phone (305) 559-7330

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41931FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Teresita D Hernandez Mdpa PastSince Nov 30, 2005 Accepting new patients

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427067149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SW 107TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653633",
            "telephone_number": "305-559-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SW 107TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653633",
            "telephone_number": "305-559-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLADARES",
        "first_name": "JUAN",
        "middle_name": "AUGUSTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "41931",
            "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 Jul 8, 2007; 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.