Active NPI
Angel Vidal, M.D.
- Rheumatology Physician
- Miami, FL
National Provider Identifier
1669409637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- ME0026606
- Practice address
- 11880 SW 40TH St
Suite 202
Miami, FL 33175-3584 - Phone
- (305) 552-7020
- Fax
- (305) 552-7006
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | ME0026606 | FL | Primary |
Addresses
Primary practice location
11880 SW 40TH St
Suite 202
Miami, FL 33175-3584
Mailing address
11880 SW 40TH St
Suite 202
Miami, FL 33175-3584
Phone (305) 552-7020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 059197100 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0026606 | FL | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280448000000",
"number": "1669409637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11880 SW 40TH ST",
"address_2": "SUITE 202",
"city": "MIAMI",
"state": "FL",
"postal_code": "331753584",
"telephone_number": "305-552-7020",
"fax_number": "305-552-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11880 SW 40TH ST",
"address_2": "SUITE 202",
"city": "MIAMI",
"state": "FL",
"postal_code": "331753584",
"telephone_number": "305-552-7020",
"fax_number": "305-552-7006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDAL",
"first_name": "ANGEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2010-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "FL",
"license": "ME0026606",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "059197100",
"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 Jul 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.