Individual provider Active NPI

Valeria Cristina Jimenez Vaca, MD

  • Internal Medicine Physician
  • Lauderhill, FL
National Provider Identifier
1689237190
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME156980 Issued in FL
Practice address
7401 W Commercial Blvd
Lauderhill, FL 33319-2129
Phone
(954) 644-8800
Fax
(954) 824-1901
NPI assigned
Apr 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME156980 FL Primary

Addresses

Primary practice location

7401 W Commercial Blvd
Lauderhill, FL 33319-2129

Mailing address

7401 W Commercial Blvd
Lauderhill, FL 33319-2129
Phone (954) 644-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220804000956 FL Practitioner - Internal Medicine 8325420599 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1689237190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 W COMMERCIAL BLVD",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333192129",
            "telephone_number": "954-644-8800",
            "fax_number": "954-824-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 W COMMERCIAL BLVD",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333192129",
            "telephone_number": "954-644-8800",
            "fax_number": "954-824-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ VACA",
        "first_name": "VALERIA",
        "middle_name": "CRISTINA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME156980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderhill, FL

Sources for this page

Verify at the official NPI Registry.