Active NPI
Junior Max Destine
- General Practice Physician
- Miami, FL
National Provider Identifier
1851884282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 26869
- Practice address
- 3663 South Miami Ave
Miami, FL 33133 - Phone
- (202) 517-5529
- NPI assigned
- Jun 11, 2018
- 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 26869 | FL | Primary |
Addresses
Primary practice location
3663 South Miami Ave
Miami, FL 33133
Mailing address
7513 Maple Ave Apt 305
Takoma Park, MD 20912-4949
Phone (202) 517-5529
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 |
|---|---|---|---|
| 26869 | FL | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1851884282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7513 MAPLE AVE APT 305",
"city": "TAKOMA PARK",
"state": "MD",
"postal_code": "209124949",
"telephone_number": "202-517-5529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3663 SOUTH MIAMI AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "33133",
"telephone_number": "202-517-5529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESTINE",
"first_name": "JUNIOR",
"middle_name": "MAX",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-11",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "26869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.