Individual provider Active NPI

Maria De Los Angeles Talavera-Carballo, PA-C

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1851860126
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111694 Issued in FL
Practice address
1321 NW 14TH St Ste 600
Miami, FL 33125-1659
Phone
(305) 243-0783
Fax
(305) 243-0790
NPI assigned
Nov 16, 2018
Last updated
Nov 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111694 FL Primary

Addresses

Primary practice location

1321 NW 14TH St Ste 600
Miami, FL 33125-1659

Mailing address

1321 NW 14TH St Ste 600
Miami, FL 33125-1659
Phone (305) 243-0783

Other identifiers 1

IdentifierTypeStateIssuer
C07090MedicaidMD

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201015000257 FL Practitioner - Physician Assistant 8820339708 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Aug 7, 2020 Accepting new patients
University of Miami CurrentSince Aug 7, 2020 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1321 NW 14th St
Ste 600
Miami, FL 33125
Phone (305) 547-2534

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1851860126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 NW 14TH ST STE 600",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251659",
            "telephone_number": "305-243-0783",
            "fax_number": "305-243-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 NW 14TH ST STE 600",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251659",
            "telephone_number": "305-243-0783",
            "fax_number": "305-243-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALAVERA-CARBALLO",
        "first_name": "MARIA",
        "middle_name": "DE LOS ANGELES",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-16",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C07090",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.