Individual provider Active NPI

Abel Valdes Diaz

  • General Practice Physician
  • Miami Gardens, FL
National Provider Identifier
1609567890
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1533 Issued in FL
Practice address
900 Park Centre Blvd Ste 400a
Miami Gardens, FL 33169-5371
Phone
(305) 912-8603
Fax
(305) 907-5343
NPI assigned
May 17, 2023
Last updated
Dec 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN1533 FL Primary

Addresses

Primary practice location

900 Park Centre Blvd Ste 400a
Miami Gardens, FL 33169-5371

Mailing address

5871 Coral Way
Miami, FL 33155-2272
Phone (786) 400-3405

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240130000168 FL Practitioner - General Practice 4385097062 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN1533FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tu Salud Medical Services Inc Single Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

900 Park Centre Blvd
Miami Gardens, FL 33169
Phone (305) 912-8603

900 Park Centre Blvd
Ste 400A
Miami Gardens, FL 33169
Phone (305) 912-8603

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1609567890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5871 CORAL WAY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331552272",
            "telephone_number": "786-400-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PARK CENTRE BLVD STE 400A",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695371",
            "telephone_number": "305-912-8603",
            "fax_number": "305-907-5343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES DIAZ",
        "first_name": "ABEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.