Active NPI
Maryanne Vaca, DO
- Student in an Organized Health Care Education/Training Program
- Pembroke Pines, FL
National Provider Identifier
1821848946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 703 N Flamingo Rd
Pembroke Pines, FL 33028-1006 - Phone
- (954) 265-4461
- NPI assigned
- Mar 22, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
703 N Flamingo Rd
Pembroke Pines, FL 33028-1006
Mailing address
4465 SW 160TH Ave Apt 206
Miramar, FL 33027-5734
Phone (305) 316-9589
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240703003926 | FL | Order and Referring Only - Pediatric Medicine | 1557805363 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711065600000",
"number": "1821848946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4465 SW 160TH AVE APT 206",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330275734",
"telephone_number": "305-316-9589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 N FLAMINGO RD",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330281006",
"telephone_number": "954-265-4461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VACA",
"first_name": "MARYANNE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-22",
"last_updated": "2024-03-22",
"certification_date": "2024-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.