Individual provider Active NPI

Jose I Pradere, MD

  • Pediatrics Physician
  • Miami, FL
National Provider Identifier
1639187040
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME28209 Issued in FL
Practice address
815 NW 57TH Ave Ste 110
Miami, FL 33126-2041
Phone
(305) 856-6371
Fax
(305) 262-2545
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME28209 FL
Pediatrics Physician 208000000X ME28209 FL Primary

Addresses

Primary practice location

815 NW 57TH Ave Ste 110
Miami, FL 33126-2041

Mailing address

815 NW 57TH Ave Ste 110
Miami, FL 33126-2041
Phone (305) 856-6371

Other identifiers 1

IdentifierTypeStateIssuer
037177700MedicaidFL

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

LicenseStateTypeSpecialty
ME28209FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jose I. Pradere, MD PA Pediatrics CurrentSince Feb 19, 2023 Accepting new patients

Locations

815 NW 57th Ave
Ste 110
Miami, FL 33126
Phone (305) 267-8885

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1639187040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 NW 57TH AVE STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262041",
            "telephone_number": "305-856-6371",
            "fax_number": "305-262-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 NW 57TH AVE STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262041",
            "telephone_number": "305-856-6371",
            "fax_number": "305-262-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADERE",
        "first_name": "JOSE",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME28209",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME28209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037177700",
            "state": "FL"
        }
    ],
    "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 Apr 9, 2025; 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.