Individual provider Active NPI

Juan Carlos Pantoja Miranda, MD

  • Student in an Organized Health Care Education/Training Program
  • South Miami, FL
National Provider Identifier
1457043093
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
42018 Issued in FL
Practice address
7031 SW 62ND Ave
South Miami, FL 33143-4701
Phone
(750) 030-5284
NPI assigned
May 23, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X 42018 FL Primary

Addresses

Primary practice location

7031 SW 62ND Ave
South Miami, FL 33143-4701

Mailing address

999 Brickell Bay Dr Apt 1608
Miami, FL 33131-2932
Phone (754) 301-1696

Other practice location 1

2320 NE 9th St Ste 300
Fort Lauderdale, FL 33304-3590
Phone (954) 563-4500 ext. 105

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
42018FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Vanguard Plastic Surgery LLC Single Specialty CurrentSince Aug 1, 2024 Accepting new patients
Michael C. Cheung, M.D., P.a. Single Specialty PastSince Aug 1, 2024 Accepting new patients

Locations

2320 NE 9th St
Ste 300
Ft Lauderdale, FL 33304
Phone (954) 536-4500

Organizations & group practices 2

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": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1457043093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 BRICKELL BAY DR APT 1608",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331312932",
            "telephone_number": "754-301-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 SW 62ND AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434701",
            "telephone_number": "750-030-5284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2320 NE 9th St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333043590",
            "country_code": "US",
            "telephone_number": "954-563-4500 x105",
            "fax_number": "954-530-0399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTOJA MIRANDA",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "42018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.