Hector Ivan Pallavicini, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME38774 Issued in FL

Practice address

3499 W 4TH Ave
Suite 201
Hialeah, FL 33012-4333

Phone

(305) 558-0411

Fax

(305) 863-3802

NPI assigned

Mar 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1992764831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3499 W 4TH AVE",
            "address_2": "SUITE 201",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124333",
            "telephone_number": "305-558-0411",
            "fax_number": "305-863-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3499 W 4TH AVE",
            "address_2": "SUITE 201",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124333",
            "telephone_number": "305-558-0411",
            "fax_number": "305-863-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLAVICINI",
        "first_name": "HECTOR",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME38774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066747100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.