Individual provider Active NPI

Alberto Ulloa Candelario, SA-C

  • Surgical Assistant
  • Miami, FL
National Provider Identifier
1649080698
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
24-569 Issued in FL
Practice address
22528 SW 109TH CT
Miami, FL 33170-6599
Phone
(786) 722-0192
NPI assigned
Jan 11, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 24-569 FL Primary

Addresses

Primary practice location

22528 SW 109TH CT
Miami, FL 33170-6599

Mailing address

22528 SW 109TH CT
Miami, FL 33170-6599
Phone (786) 722-0192

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
24-569FLMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1736553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1649080698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22528 SW 109TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331706599",
            "telephone_number": "786-722-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22528 SW 109TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331706599",
            "telephone_number": "786-722-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLOA CANDELARIO",
        "first_name": "ALBERTO",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-11",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "24-569",
            "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 Jan 11, 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.