Individual provider Active NPI

Juan Sebastian Vargas Nino

  • Clinical Social Worker
  • Coconut Creek, FL
National Provider Identifier
1518857879
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW20455 Issued in FL
Practice address
6800 NW 39TH Ave Lot 175
Coconut Creek, FL 33073-3296
Phone
(561) 376-0165
NPI assigned
Jul 8, 2025
Last updated
Jul 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW20455 FL Primary

Addresses

Primary practice location

6800 NW 39TH Ave Lot 175
Coconut Creek, FL 33073-3296

Mailing address

6800 NW 39TH Ave Lot 175
Coconut Creek, FL 33073-3296
Phone (561) 376-0165

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

State licenses

LicenseStateTypeSpecialty
ISW20455FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1518857879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 NW 39TH AVE LOT 175",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733296",
            "telephone_number": "561-376-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 NW 39TH AVE LOT 175",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733296",
            "telephone_number": "561-376-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS NINO",
        "first_name": "JUAN",
        "middle_name": "SEBASTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW20455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.