Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Enrique Xavier Vaca, PA-C

Individual provider Physician Assistant · NPI 1104310267

Enrique Xavier Vaca, PA-C is a Physician Assistant in Clearwater, Florida. Qualified in 2017, 9 years ago. Practices with Florida Kidney Physicians LLC, a 168-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
9
Licensed in
FL
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

525 S Hercules Ave Ste 102
Clearwater, FL 33764-6320
Phone: (727) 442-6068
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9110684 (FL)

Record details

NPI number1104310267
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 21, 2018
Last updated in NPPESSeptember 24, 2025
Certification dateSeptember 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Florida Kidney Physicians Llc — 168 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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