Individual provider Active NPI

Antonio Miguel Vazquez-Pausa, LCSW

  • Clinical Social Worker
  • Miami, FL
National Provider Identifier
1700088812
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW3712 Issued in FL
Practice address
9350 SW 72ND St
Miami, FL 33173-3245
Phone
(305) 595-2590
Fax
(305) 595-3746
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW3712 FL
Clinical Social Worker 1041C0700X SW3712 FL Primary

Addresses

Primary practice location

9350 SW 72ND St
Miami, FL 33173-3245

Mailing address

6101 SW 15TH St
West Miami, FL 33144-5751
Phone (305) 788-4590

Other practice location 1

3510 Biscayne Blvd
Miami, FL 33137-3840
Phone (305) 576-1234 ext. 123

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114003777 FL Practitioner - Clinical Social Worker 3779930656 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW3712FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Care Resource Community Health Centers, Inc Current Accepting new patients
Care Resource Community Health Centers, Inc. CurrentSince Jun 24, 2023 Accepting new patients
Care Resource Community Health Centers, Inc. CurrentSince Jun 24, 2023 Accepting new patients

Locations

3510 Biscayne Blvd
Miami, FL 33137
Phone 3055761234282

1680 Michigan Ave
Ste 912
Miami Beach, FL 33139
Phone (305) 534-0503

3160 Powerline Rd
Oakland Park, FL 33309
Phone (305) 773-7844

871 W Oakland Park Blvd
Wilton Manors, FL 33311
Phone (954) 567-7141

Interoperability endpoints

  • Direct secure messaging: antonio.vazquezpausa.p1@direct.careresource.nextgenshare.com

Organizations & group practices 3

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1700088812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 SW 15TH ST",
            "city": "WEST MIAMI",
            "state": "FL",
            "postal_code": "331445751",
            "telephone_number": "305-788-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 SW 72ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733245",
            "telephone_number": "305-595-2590",
            "fax_number": "305-595-3746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3510 Biscayne Blvd",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331373840",
            "country_code": "US",
            "telephone_number": "305-576-1234 x123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ-PAUSA",
        "first_name": "ANTONIO",
        "middle_name": "MIGUEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW3712",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.