NPIMap

Individual provider Active NPI

Eduardo Jose Vasquez, MD

  • Pulmonary Disease Physician
  • Miami, FL
National Provider Identifier
1760426597
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
115155 Issued in FL
Practice address
12905 SW 42ND St Ste 213
Miami, FL 33175-2912
Phone
(786) 507-8830
Fax
(786) 294-6802
NPI assigned
Jun 15, 2006
Last updated
Feb 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 23545 NE
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 115155 FL Primary

Addresses

Primary practice location

12905 SW 42ND St Ste 213
Miami, FL 33175-2912

Mailing address

12905 SW 42ND St Ste 213
Miami, FL 33175-2912
Phone (786) 507-8830

Other identifiers 2

IdentifierTypeStateIssuer
115155OtherFLSTATE LICENSE
23545OtherNESTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130308000039 FL Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 3779589825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12905 SW 42ND St
Suite 213
Miami, FL 33175-2912
Phone (786) 382-7634

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Vasquez Pulmonary Consultants Inc Single Specialty CurrentSince Jun 14, 2018 Accepting new patients
Intensive Care Consortium Inc Single Specialty Past Accepting new patients

Locations

12905 SW 42nd St
Ste 213
Miami, FL 33175
Phone (305) 705-5651

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1760426597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12905 SW 42ND ST STE 213",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331752912",
            "telephone_number": "786-507-8830",
            "fax_number": "786-294-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12905 SW 42ND ST STE 213",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331752912",
            "telephone_number": "786-507-8830",
            "fax_number": "786-294-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "EDUARDO",
        "middle_name": "JOSE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NE",
            "license": "23545",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "115155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "115155",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "23545",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.