Rafael G Balboa, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN20434 Issued in FL

Practice address

14527 SW 42ND St
Miami, FL 33175-7801

Phone

(786) 488-2895

Fax

(305) 328-9636

NPI assigned

Nov 4, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Balboa and Associates Dental Group

  • General Practice Dentistry
  • Miami, FL
  • NPI 1639541659
  NPD (past) Authorized official

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1497184097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14527 SW 42ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33175",
            "telephone_number": "786-488-2895",
            "fax_number": "305-328-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14527 SW 42ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331757801",
            "telephone_number": "786-488-2895",
            "fax_number": "305-328-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBOA",
        "first_name": "RAFAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-04",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Balboa and Associates Dental Group
• Omar Balboa Lopez, CSA
• Allison Balboa
• Audrey Balboa
• Norka Balboa, OT
• Yahima Balboa, PA-C
• Jacqueline Balbuena, DO
• Frank Balbusano Cabrera
• Patricia Balcacer de la Cruz, M.D.
• Ana Leonor Balcazar, ARNP

• Dentist in Miami, FL
• Providers in Miami, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.