Active NPI
Pablo Sicilia, MR
- Clinic/Center
- Miami, FL
National Provider Identifier
1790914786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- MA51624
- Practice address
- 711 NW 23Rd Ave
Suite 204
Miami, FL 33125-3298 - Phone
- (305) 644-4464
- Fax
- (305) 644-4464
- NPI assigned
- Jul 10, 2009
- Sex
- Male
- 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 | MA51624 | FL | Primary |
Addresses
Primary practice location
711 NW 23Rd Ave
Suite 204
Miami, FL 33125-3298
Mailing address
711 NW 23Rd Ave
Suite 204
Miami, FL 33125-3298
Phone (305) 644-4464
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 |
|---|---|---|---|
| MA51624 | FL | MD | Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309824000000",
"number": "1790914786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 NW 23RD AVE",
"address_2": "SUITE 204",
"city": "MIAMI",
"state": "FL",
"postal_code": "331253298",
"telephone_number": "305-644-4464",
"fax_number": "305-644-4464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 NW 23RD AVE",
"address_2": "SUITE 204",
"city": "MIAMI",
"state": "FL",
"postal_code": "331253298",
"telephone_number": "305-644-4464",
"fax_number": "305-644-4464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SICILIA",
"first_name": "PABLO",
"name_prefix": "Mr.",
"credential": "MR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-10",
"last_updated": "2011-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "FL",
"license": "MA51624",
"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 Jul 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.