NPIMap

Organization Active NPI

South Miami Sports Medicine Inc.

  • Exclusive Provider Organization
  • South Miami, FL
National Provider Identifier
1013211705
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
OT2468 Issued in FL
Legal business name
SOUTH MIAMI SPORTS MEDICINE INC.
Practice address
7000 SW 62ND Ave
Suite 120
South Miami, FL 33143-4716
Phone
(305) 666-7168
NPI assigned
Jan 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Authorized official

Name
Mr. Robert A Millares, OTRL,CHTNPI 1255349007
Title
President/Owner
Phone
(305) 666-7116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X OT2468 FL Primary

Addresses

Primary practice location

7000 SW 62ND Ave
Suite 120
South Miami, FL 33143-4716

Mailing address

7000 S.W. 62 Avenue
Suite 120
Miami, FL 33143
Phone (305) 666-7168

National Provider Directory

National Provider Directory

Locations

7000 SW 62nd Ave
Ste 120
South Miami, FL 33143
Phone (305) 666-7116

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1013211705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 S.W. 62 AVENUE",
            "address_2": "SUITE 120",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33143",
            "telephone_number": "305-666-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 SW 62ND AVE",
            "address_2": "SUITE 120",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434716",
            "telephone_number": "305-666-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MIAMI SPORTS MEDICINE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "MILLARES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "305-666-7116",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTRL,CHT"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "FL",
            "license": "OT2468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.