Individual provider Active NPI

Rafael Quiroz, PA-C

  • Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1508002882
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9102196 Issued in FL
Practice address
17901 NW 5TH St
Pembroke Pines, FL 33029-2810
Phone
(954) 442-8380
NPI assigned
Dec 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9102196 FL Primary

Addresses

Primary practice location

17901 NW 5TH St
Pembroke Pines, FL 33029-2810

Mailing address

2138 SW 176TH Ter
Miramar, FL 33029-5258
Phone (954) 441-5140

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121009000142 FL Practitioner - Physician Assistant 9335398254 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solantic/South Florida LLCGroup PAC ID 5496762171, 27 clinicians
West Boynton Urgent Care LLCGroup PAC ID 0941456537, 7 clinicians

Practice addresses (Care Compare)

1205 N University Dr
Coral Springs, FL 33071-6620
Phone (954) 780-8134

1611 S Federal Hwy
Pompano Beach, FL 33062-7514
Phone (954) 580-4001

18203 Pines Blvd
Pembroke Pines, FL 33029-1417
Phone (954) 889-5823

18706 NW 67TH Ave
Carespot Miami Gardens
Hialeah, FL 33015-2408
Phone (786) 563-0280

9035 Pines Blvd
Pembroke Pines, FL 33024-6440
Phone (954) 378-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 5

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": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1508002882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 SW 176TH TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295258",
            "telephone_number": "954-441-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 NW 5TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292810",
            "telephone_number": "954-442-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIROZ",
        "first_name": "RAFAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-17",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.