Individual provider Active NPI

Vladimir I Padron, MA

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1720359482
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11006721 Issued in FL
Practice address
21 NW 136TH CT
Miami, FL 33182-1932
Phone
(305) 281-0820
Fax
(305) 388-2613
NPI assigned
Jan 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA65506 FL
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 11006721 FL Primary

Addresses

Primary practice location

21 NW 136TH CT
Miami, FL 33182-1932

Mailing address

21 NW 136TH CT
Miami, FL 33182-1932
Phone (305) 281-0820

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818000797 FL Practitioner - Nurse Practitioner 7416373725 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
MA65506FLMDMassage Therapist
11006721FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Associates, LLC. Single Specialty CurrentSince Jul 17, 2021 Accepting new patients

Locations

2801 W 12th Ave
Hialeah, FL 33010
Phone (305) 805-9500

10860 SW 88th St
Miami, FL 33176
Phone (305) 552-5545

606 W Flagler St
Miami, FL 33130
Phone (305) 545-9292

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": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1720359482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 NW 136TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331821932",
            "telephone_number": "305-281-0820",
            "fax_number": "305-388-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 NW 136TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331821932",
            "telephone_number": "305-281-0820",
            "fax_number": "305-388-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRON",
        "first_name": "VLADIMIR",
        "middle_name": "I",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-25",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA65506",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11006721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.