Individual provider Active NPI

Jaime Mauricio Herrera, OBHCMS

  • Case Manager/Care Coordinator
  • Miami, FL
National Provider Identifier
1649026543
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CBHCMS.0102663 Issued in FL
Practice address
22790 SW 112TH Ave
Miami, FL 33170-7602
Phone
(305) 235-2616
NPI assigned
Apr 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CBHCMS.0102663 FL Primary

Addresses

Primary practice location

22790 SW 112TH Ave
Miami, FL 33170-7602

Mailing address

22790 SW 112TH Ave
Miami, FL 33170-7602
Phone (305) 235-2616

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

State licenses

LicenseStateTypeSpecialty
CBHCMS.0102663FLMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1649026543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22790 SW 112TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331707602",
            "telephone_number": "305-235-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22790 SW 112TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331707602",
            "telephone_number": "305-235-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "JAIME",
        "middle_name": "MAURICIO",
        "credential": "OBHCMS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "CBHCMS.0102663",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 30, 2024; 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.