Organization Active NPI

Hernan R Baquerizo MD PA

  • Specialist
  • Miami, FL
National Provider Identifier
1720263833
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HERNAN R BAQUERIZO MD PA
Practice address
3661 S Miami Ave
Suite 505
Miami, FL 33133-4200
Phone
(305) 859-9840
NPI assigned
Jan 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Authorized official

Name
Dr. Hernan R Baquerizo, MDNPI 1053378893
Title
Owner
Phone
(305) 859-9840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3661 S Miami Ave
Suite 505
Miami, FL 33133-4200

Mailing address

3661 S Miami Ave
Suite 505
Miami, FL 33133-4200
Phone (305) 859-9840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000192 FL Part B Supplier - Clinic/Group Practice 0749173136 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL; Coral Gables, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1032334Hernan R Baquerizo MD PA3661 S Miami Ave ,Ste 505, Miami, FL 33133Certificate of waiverOct 20, 2026

National Provider Directory

National Provider Directory

Locations

3663 S Miami Ave
Fl 4
Miami, FL 33133
Phone (305) 285-2939

3661 S Miami Ave
Ste 203
Miami, FL 33133
Phone (305) 854-5432

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1720263833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 S MIAMI AVE",
            "address_2": "SUITE 505",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334200",
            "telephone_number": "305-859-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 S MIAMI AVE",
            "address_2": "SUITE 505",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334200",
            "telephone_number": "305-859-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERNAN R BAQUERIZO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "BAQUERIZO",
        "authorized_official_first_name": "HERNAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-859-9840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "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 Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.