Individual provider Active NPI

Manuel Alvarez Jacinto, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Key Biscayne, FL
National Provider Identifier
1629529433
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9109866 Issued in FL
Practice address
240 Crandon Blvd Ste 110
Key Biscayne, FL 33149
Phone
(786) 595-8252
Fax
(786) 533-9509
NPI assigned
Oct 17, 2016
Last updated
Dec 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9109866 FL Primary

Addresses

Primary practice location

240 Crandon Blvd Ste 110
Key Biscayne, FL 33149

Mailing address

240 Crandon Blvd Ste 110
Key Biscayne, FL 33149-1543
Phone (786) 595-8252

Other practice location 1

240 Crandon Blvd Ste 110
Key Biscayne, FL 33149
Phone (786) 595-8252

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170719000841 FL Practitioner - Physician Assistant 0547530818 Reassigns benefits to 10 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9109866FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Feb 15, 2023 Accepting new patients
Baptist Outpatient Services Inc CurrentSince Jul 3, 2020 Accepting new patients
South Broward Hospital District CurrentSince Feb 15, 2023 Accepting new patients
Emergent Physicians of Country Walk, LLC Past Accepting new patients
Dispatchhealth-Florida Inc. PastSince Aug 1, 2021 Accepting new patients

Locations

6264 W Sample Rd
Ste 120
Coral Springs, FL 33067
Phone (954) 837-1020

13001 SW 88th St
Miami, FL 33186
Phone (786) 596-3800

240 Crandon Blvd
Ste 110
Miami, FL 33149
Phone (786) 595-8250

8840 SW 40th St
Ste 100
Miami, FL 33165
Phone (786) 596-3890

8950 N Kendall Dr
Fl 2
Miami, FL 33176
Phone (786) 596-7200

8750 SW 144th St
Palmetto Bay, FL 33176
Phone (786) 596-3840

8750 SW 144th St
Ste 100
Palmetto Bay, FL 33176
Phone (305) 253-5585

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Interoperability endpoints

  • Direct secure messaging: malvarezjacinto4075326@direct.trinity-health.org

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1629529433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CRANDON BLVD STE 110",
            "city": "KEY BISCAYNE",
            "state": "FL",
            "postal_code": "331491543",
            "telephone_number": "786-595-8252",
            "fax_number": "786-533-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CRANDON BLVD STE 110",
            "city": "KEY BISCAYNE",
            "state": "FL",
            "postal_code": "33149",
            "telephone_number": "786-595-8252",
            "fax_number": "786-533-9509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Crandon Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Key Biscayne",
            "state": "FL",
            "postal_code": "33149",
            "country_code": "US",
            "telephone_number": "786-595-8252",
            "fax_number": "786-533-9509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALVAREZ JACINTO",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9109866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Key Biscayne, FL

Sources for this page

Verify at the official NPI Registry.