Individual provider Active NPI

Carmen Maria Martinez Mora, SA-C

  • Surgical Assistant
  • Miami, FL
National Provider Identifier
1609407956
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
19-530 Issued in FL
Practice address
9365 SW 77TH Ave Apt 2010
Miami, FL 33156-7941
Phone
(646) 683-5477
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 19-530 FL Primary

Addresses

Primary practice location

9365 SW 77TH Ave Apt 2010
Miami, FL 33156-7941

Mailing address

9365 SW 77TH Ave Apt 2010
Miami, FL 33156-7941
Phone (646) 683-5477

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
19-530FLMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1609407956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9365 SW 77TH AVE APT 2010",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331567941",
            "telephone_number": "646-683-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9365 SW 77TH AVE APT 2010",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331567941",
            "telephone_number": "646-683-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ MORA",
        "first_name": "CARMEN",
        "middle_name": "MARIA",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "19-530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.