Active NPI
Mirella Suarez Troccoli, MD
- Pediatrics Physician
- Hollywood, FL
National Provider Identifier
1982693545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME73894
- Practice address
- 10000 Stirling Rd
Suite 6
Hollywood, FL 33024-8067 - Phone
- (954) 365-3200
- Fax
- (954) 365-3205
- NPI assigned
- Oct 17, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME73894 | FL | Primary |
Addresses
Primary practice location
10000 Stirling Rd
Suite 6
Hollywood, FL 33024-8067
Mailing address
10000 Stirling Rd
Suite 6
Hollywood, FL 33024-8067
Phone (954) 365-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 253512200 | 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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME73894 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitalmd Group Holding LLC | Pediatrics | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311724800000",
"number": "1982693545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10000 STIRLING RD",
"address_2": "SUITE 6",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330248067",
"telephone_number": "954-365-3200",
"fax_number": "954-365-3205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 STIRLING RD",
"address_2": "SUITE 6",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330248067",
"telephone_number": "954-365-3200",
"fax_number": "954-365-3205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUAREZ TROCCOLI",
"first_name": "MIRELLA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-17",
"last_updated": "2011-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME73894",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "253512200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.