Active NPI
Enrique Rueda Medical Corp
- Medical Physician Assistant
- Miami, FL
National Provider Identifier
1679845333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9101498
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 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 DirectoryNPI 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.