Active NPI
Juan Carlos Pantoja Miranda, MD
- Student in an Organized Health Care Education/Training Program
- South Miami, FL
National Provider Identifier
1457043093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 42018
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 42018 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vanguard Plastic Surgery LLC | Single Specialty | Current | Accepting new patients |
| Michael C. Cheung, M.D., P.a. | Single Specialty | Past | 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.
-
dba Vanguard Aesthetic & Plastic Surgery
- Plastic Surgery Physician
- Fort Lauderdale, FL
- NPI 1962889204
Single Specialty
-
- Plastic Surgery Physician
- Fort Lauderdale, FL
- NPI 1750769329
Single Specialty
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.