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

Ivan Ernesto Kidd Baralt, SA-C

Individual provider Physician Assistant · NPI 1790651917

Ivan Ernesto Kidd Baralt, SA-C is a Physician Assistant in Miami, Florida. Practices as a sole proprietor. Licensed in Florida and Puerto Rico.

Licensed in
FL, PR
In the registry since
2025
Specialties on file
2

Practice location Address checks out

145 SW 8th St Unit 2101
Miami, FL 33130-3664
Phone: (305) 322-7894
Fax: (305) 322-7894
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X · Licence 20-190 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 2832-P.A. (PR)

Record details

NPI number1790651917
Entity typeIndividual (Type 1)
GenderMale
Credentials SA-C
Sole proprietorYes
NPI enumeratedOctober 14, 2025
Last updated in NPPESOctober 24, 2025
Certification dateOctober 14, 2025

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