Active NPI
Howard R Wilkov, MD
- Diagnostic Radiology Physician
- Miami, FL
National Provider Identifier
1871571836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME25503
- Practice address
- 1475 NW 12TH Ave
Miami, FL 33136-1002 - Phone
- (305) 243-5512
- Fax
- (305) 243-4613
- NPI assigned
- Jan 9, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 25503 | FL | |
| Diagnostic Radiology Physician | 2085R0202X | ME25503 | FL | Primary |
Addresses
Primary practice location
1475 NW 12TH Ave
Miami, FL 33136-1002
Mailing address
1475 NW 12TH Ave
Miami, FL 33136-1002
Phone (305) 243-5512
Other practice location 1
3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 987-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 049281700 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25503 | FL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Florida Medical Imaging, PA | Diagnostic Radiology | 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.
-
- Diagnostic Radiology Physician
- Ft Lauderdale, FL
- NPI 1518945575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511222400000",
"number": "1871571836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1475 NW 12TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361002",
"telephone_number": "305-243-5512",
"fax_number": "305-243-4613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 NW 12TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361002",
"telephone_number": "305-243-5512",
"fax_number": "305-243-4613"
}
],
"practiceLocations": [
{
"address_1": "3501 Johnson St",
"address_purpose": "LOCATION",
"city": "Hollywood",
"state": "FL",
"postal_code": "330215421",
"country_code": "US",
"telephone_number": "954-987-2000",
"fax_number": "954-437-6628",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILKOV",
"first_name": "HOWARD",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2017-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "25503",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME25503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "049281700",
"state": "FL"
}
],
"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 Nov 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.