Individual provider Active NPI

Juan C Palacios, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Miami, FL
National Provider Identifier
1447216015
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME84519 Issued in FL
Practice address
1611 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1005
Phone
(305) 243-6484
Fax
(305) 243-8470
NPI assigned
Apr 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME84519 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1005

Mailing address

1611 NW 12TH Ave
Box 016960 M851
Miami, FL 33136-1005
Phone (305) 243-6484

Other identifiers 1

IdentifierTypeStateIssuer
2744546-00MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220301001801 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2769496660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: jpalacios5835@direct.med.miami.edu

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1447216015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "BOX 016960 M851",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-6484",
            "fax_number": "305-243-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "BOX 016960 M851",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-243-6484",
            "fax_number": "305-243-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACIOS",
        "first_name": "JUAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME84519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2744546-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.