Active NPI
Rafael Dejesus Mota, PA
- Physician Assistant
- Coral Gables, FL
National Provider Identifier
1720192156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9100826
- Practice address
- 3940 W Flagler St
Suite 201
Coral Gables, FL 33134-1613 - Phone
- (786) 566-9900
- Fax
- (305) 266-0135
- NPI assigned
- Aug 19, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9100826 | FL | Primary |
Addresses
Primary practice location
3940 W Flagler St
Suite 201
Coral Gables, FL 33134-1613
Mailing address
15483 SW 12 Terrace
Miami, FL 33194
Phone (305) 266-0135
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
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720192156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15483 SW 12 TERRACE",
"city": "MIAMI",
"state": "FL",
"postal_code": "33194",
"telephone_number": "305-266-0135",
"fax_number": "786-556-9900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3940 W FLAGLER ST",
"address_2": "SUITE 201",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331341613",
"telephone_number": "786-566-9900",
"fax_number": "305-266-0135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOTA",
"first_name": "RAFAEL",
"middle_name": "DEJESUS",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9100826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Gables, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.