Active NPI
Wolf Montfort Perceval
- Surgical Assistant
- Miami, FL
National Provider Identifier
1780401208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 14-500
- Practice address
- 3663 S Miami Ave
Miami, FL 33133-4253 - Phone
- (305) 854-4400
- NPI assigned
- Sep 25, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 14-500 | FL | Primary |
Addresses
Primary practice location
3663 S Miami Ave
Miami, FL 33133-4253
Mailing address
24553 SW 115TH CT
Princeton, FL 33032-4711
Phone (239) 285-5016
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 |
|---|---|---|---|
| 14-500 | FL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1780401208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24553 SW 115TH CT",
"city": "PRINCETON",
"state": "FL",
"postal_code": "330324711",
"telephone_number": "239-285-5016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3663 S MIAMI AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331334253",
"telephone_number": "305-854-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERCEVAL",
"first_name": "WOLF",
"middle_name": "MONTFORT",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-25",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "FL",
"license": "14-500",
"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 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.