Individual provider Active NPI

Manual Dearriba, CSA

  • Surgical Assistant
  • Miami, FL
National Provider Identifier
1881415271
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
22-785 Issued in FL
Practice address
3663 S Miami Ave
Miami, FL 33133-4253
Phone
(305) 854-4400
NPI assigned
Oct 18, 2024
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 22-785 FL Primary

Addresses

Primary practice location

3663 S Miami Ave
Miami, FL 33133-4253

Mailing address

3 Maryland Farms Ste 200
Brentwood, TN 37027-5780
Phone (800) 348-4565

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

LicenseStateTypeSpecialty
22-785FLMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1881415271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARYLAND FARMS STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275780",
            "telephone_number": "800-348-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 S MIAMI AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334253",
            "telephone_number": "305-854-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARRIBA",
        "first_name": "MANUAL",
        "credential": "CSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "22-785",
            "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 Oct 18, 2024; 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.