Individual provider Active NPI

Pierre-Richard Edouard, M.D.

  • Family Medicine Physician
  • Miami Lakes, FL
National Provider Identifier
1851325112
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME80989 Issued in FL
Practice address
16161 NW 57TH Ave
Miami Lakes, FL 33014-6707
Phone
(305) 625-3409
Fax
(305) 625-2734
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME80989 FL Primary

Addresses

Primary practice location

16161 NW 57TH Ave
Miami Lakes, FL 33014-6707

Mailing address

16161 NW 57TH Ave
Miami Lakes, FL 33014-6707
Phone (305) 625-3409

Other identifiers 1

IdentifierTypeStateIssuer
260320900MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1851325112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16161 NW 57TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146707",
            "telephone_number": "305-625-3409",
            "fax_number": "305-625-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16161 NW 57TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146707",
            "telephone_number": "305-625-3409",
            "fax_number": "305-625-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDOUARD",
        "first_name": "PIERRE-RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME80989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260320900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.