Active NPI
Yanick Perodin, M.D.
- Pediatrics Physician
- Opalocka, FL
National Provider Identifier
1609802438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME0043125
- Practice address
- 16555 NW 25TH Ave
North Dade Health Center
Opalocka, FL 33054 - Phone
- (786) 466-1718
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME0043125 | FL | Primary |
Addresses
Primary practice location
16555 NW 25TH Ave
North Dade Health Center
Opalocka, FL 33054
Mailing address
11305 SW 128TH St
Miami, FL 33176-4481
Phone (786) 466-1718
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 68401500 | Medicaid | FL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0043125 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609802438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11305 SW 128TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331764481",
"telephone_number": "786-466-1718",
"fax_number": "305-626-4854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16555 NW 25TH AVE",
"address_2": "NORTH DADE HEALTH CENTER",
"city": "OPALOCKA",
"state": "FL",
"postal_code": "33054",
"telephone_number": "786-466-1718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERODIN",
"first_name": "YANICK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME0043125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "68401500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Opalocka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.