Organization Active NPI

Mercedes J Vazquez MD PA

  • Internal Medicine Physician
  • Homestead, FL
National Provider Identifier
1619243391
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MERCEDES J VAZQUEZ MD PA
Practice address
950 N Krome Ave
Suite 203
Homestead, FL 33030-4400
Phone
(305) 242-0911
Fax
(305) 242-0912
NPI assigned
Mar 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Authorized official

Name
Mr. Mercedes J Vazquez, MDNPI 1134396724
Title
Owner
Phone
(305) 242-0911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

950 N Krome Ave
Suite 203
Homestead, FL 33030-4400

Mailing address

950 N Krome Ave
Suite 203
Homestead, FL 33030-4400
Phone (305) 242-0911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120404000389 FL Part B Supplier - Clinic/Group Practice 5799945424 Receives reassigned benefits from 1 practitioner
Practice locations: Homestead, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1619243391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N KROME AVE",
            "address_2": "SUITE 203",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304400",
            "telephone_number": "305-242-0911",
            "fax_number": "305-242-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N KROME AVE",
            "address_2": "SUITE 203",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304400",
            "telephone_number": "305-242-0911",
            "fax_number": "305-242-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCEDES J VAZQUEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "MERCEDES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-242-0911",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.