Active NPI
Vilaivanh Inthanam
- Specialist
- Coral Gables, FL
National Provider Identifier
1649406398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 50198
- Practice address
- 147 Alhambra Cir Ste 140
Coral Gables, FL 33134-4529 - Phone
- (786) 299-5290
- NPI assigned
- Jun 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 50198 | FL | Primary |
Addresses
Primary practice location
147 Alhambra Cir Ste 140
Coral Gables, FL 33134-4529
Mailing address
19841 SW 117TH CT
Miami, FL 33177-4430
Phone (786) 205-0489
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
| License | State | Type | Specialty |
|---|---|---|---|
| 50198 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244505600000",
"number": "1649406398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19841 SW 117TH CT",
"city": "MIAMI",
"state": "FL",
"postal_code": "331774430",
"telephone_number": "786-205-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 ALHAMBRA CIR STE 140",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331344529",
"telephone_number": "786-299-5290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INTHANAM",
"first_name": "VILAIVANH",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-09",
"last_updated": "2009-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "50198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Gables, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.