Organization Active NPI

Irvin H Willis MD PA

  • Surgery Physician
  • Miami Beach, FL
National Provider Identifier
1558677401
Registry record updated Aug 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME12189 Issued in FL
Legal business name
IRVIN H WILLIS MD PA
Practice address
4302 Alton Rd
Suite 630
Miami Beach, FL 33140-2891
Phone
(305) 534-6050
Fax
(305) 534-7806
NPI assigned
Aug 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2010

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

Authorized official

Name
Dr. Irvin H Willis, MD
Title
Owner
Phone
(305) 534-6050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X ME12189 FL Primary

Addresses

Primary practice location

4302 Alton Rd
Suite 630
Miami Beach, FL 33140-2891

Mailing address

4302 Alton Rd
Suite 630
Miami Beach, FL 33140-2891
Phone (305) 534-6050

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1282953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282953600000",
    "number": "1558677401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 ALTON RD",
            "address_2": "SUITE 630",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402891",
            "telephone_number": "305-534-6050",
            "fax_number": "305-534-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 ALTON RD",
            "address_2": "SUITE 630",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331402891",
            "telephone_number": "305-534-6050",
            "fax_number": "305-534-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVIN H WILLIS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-28",
        "last_updated": "2010-08-28",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "IRVIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-534-6050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME12189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2010; 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.