Individual provider Active NPI

Julian de Jesus Mazuera Pelaez

  • Surgical Assistant
  • Miami, FL
National Provider Identifier
1720629876
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
19-403 Issued in WI
Practice address
2615 SW 22ND Av
Apt 10
Miami, FL 33133
Phone
(786) 583-5199
NPI assigned
Sep 30, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 19-403 WI Primary

Addresses

Primary practice location

2615 SW 22ND Av
Apt 10
Miami, FL 33133

Mailing address

2615 SW 22ND Av
Apt 10
Miami, FL 33133
Phone (786) 583-5199

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19-403WIMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1720629876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 SW 22ND AV",
            "address_2": "APT 10",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33133",
            "telephone_number": "786-583-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 SW 22ND AV",
            "address_2": "APT 10",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33133",
            "telephone_number": "786-583-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUERA PELAEZ",
        "first_name": "JULIAN DE",
        "middle_name": "JESUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "19-403",
            "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 Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.