NPIMap

Organization Active NPI

Progressive Medical Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, FL
National Provider Identifier
1013592195
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PROGRESSIVE MEDICAL CENTER INC
Practice address
12595 SW 137TH Ave Ste 110
Miami, FL 33186-4218
Phone
(305) 465-9379
Fax
(305) 203-4672
NPI assigned
Mar 10, 2021
Last updated
Jan 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Manuel Gomez
Title
President
Phone
(305) 465-9379

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Psychiatry Physician 2084P0800X NU
Behavior Analyst 103K00000X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

12595 SW 137TH Ave Ste 110
Miami, FL 33186-4218

Mailing address

12595 SW 137TH Ave Ste 110
Miami, FL 33186-4218
Phone (305) 465-9379

Other practice location 1

10175 Fortune Pkwy Unit 602
Jacksonville, FL 32256-6752
Phone (904) 265-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210602001819 FL Part B Supplier - Clinic/Group Practice 8820497423 Receives reassigned benefits from 24 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

10175 Fortune Pkwy
Unit 602
Jacksonville, FL 32256
Phone (904) 265-2700

12595 SW 137th Ave
Ste 110
Miami, FL 33186
Phone (305) 465-9379

12595 SW 137th Ave
Ste 203
Miami, FL 33186
Phone (305) 465-9379

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1013592195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12595 SW 137TH AVE STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864218",
            "telephone_number": "305-465-9379",
            "fax_number": "305-203-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12595 SW 137TH AVE STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864218",
            "telephone_number": "305-465-9379",
            "fax_number": "305-203-4672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10175 Fortune Pkwy Unit 602",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322566752",
            "country_code": "US",
            "telephone_number": "904-265-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROGRESSIVE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-465-9379"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.