Active NPI
Bernardino Orestes Enriquez, GENERAL RADIOGRAPHER
- Radiography Radiologic Technologist
- Plantation, FL
National Provider Identifier
1811093131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiography Radiologic Technologist
- License
- 38641
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 38641 | FL | MD | Radiography Radiologic Technologist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Rehabilitation Clinic/Center
- Plantation, FL
- NPI 1003075904
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.