Active NPI
Mirta Plasencia
- Clinic/Center
- Hialeah, FL
National Provider Identifier
1750600516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- MA58262
- Practice address
- 4445 W 16TH Ave Ste 602
Hialeah, FL 33012-2960 - Phone
- (786) 334-5663
- Fax
- (786) 786-4315
- NPI assigned
- May 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | MA58262 | FL | Primary |
Addresses
Primary practice location
4445 W 16TH Ave Ste 602
Hialeah, FL 33012-2960
Mailing address
4445 W 16TH Ave Ste 602
Hialeah, FL 33012-2960
Phone (786) 334-5663
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA58262 | FL | MD | Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688515200000",
"number": "1750600516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4445 W 16TH AVE STE 602",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330122960",
"telephone_number": "786-334-5663",
"fax_number": "786-786-4315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4445 W 16TH AVE STE 602",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330122960",
"telephone_number": "786-334-5663",
"fax_number": "786-786-4315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLASENCIA",
"first_name": "MIRTA",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-19",
"last_updated": "2023-07-05",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "FL",
"license": "MA58262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.