Organization Active NPI

Enrique Rueda Medical Corp

  • Medical Physician Assistant
  • Miami, FL
National Provider Identifier
1679845333
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9101498 Issued in FL
Legal business name
ENRIQUE RUEDA MEDICAL CORP
Practice address
9409 Fontainebleau Blvd
Apt 101
Miami, FL 33172-7503
Phone
(305) 554-1491
Fax
(305) 226-4860
NPI assigned
Jan 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Authorized official

Name
Mr. Enrique J Rueda, PHYSICIAN ASSISTANT
Title
President
Phone
(305) 554-1491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA9101498 FL Primary

Addresses

Primary practice location

9409 Fontainebleau Blvd
Apt 101
Miami, FL 33172-7503

Mailing address

9409 Fontainebleau Blvd
Apt 101
Miami, FL 33172-7503
Phone (305) 554-1491

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1679845333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9409 FONTAINEBLEAU BLVD",
            "address_2": "APT 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331727503",
            "telephone_number": "305-554-1491",
            "fax_number": "305-226-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9409 FONTAINEBLEAU BLVD",
            "address_2": "APT 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331727503",
            "telephone_number": "305-554-1491",
            "fax_number": "305-226-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENRIQUE RUEDA MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "RUEDA",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-554-1491",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101498",
            "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 27, 2012; 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.