Individual provider Active NPI

Bernardino Orestes Enriquez, GENERAL RADIOGRAPHER

  • Radiography Radiologic Technologist
  • Plantation, FL
National Provider Identifier
1811093131
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
38641 Issued in FL
Practice address
4100 S Hospital Dr Ste 206
Plantation
Plantation, FL 33317-2837
Phone
(954) 321-3638
Fax
(954) 321-1422
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X 38641 FL Primary

Addresses

Primary practice location

4100 S Hospital Dr Ste 206
Plantation
Plantation, FL 33317-2837

Mailing address

12240 NW 7TH TRL
Miami, FL 33182-2408
Phone (305) 505-3619

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
38641FLMDRadiography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Plantation Rehabilitation Care Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1811093131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12240 NW 7TH TRL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331822408",
            "telephone_number": "305-505-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S HOSPITAL DR STE 206",
            "address_2": "PLANTATION",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172837",
            "telephone_number": "954-321-3638",
            "fax_number": "954-321-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "BERNARDINO",
        "middle_name": "ORESTES",
        "credential": "GENERAL RADIOGRAPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "FL",
            "license": "38641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.