NPIMap

Organization Active NPI

Ark Provision Enterprises, Inc.

  • Developmental Disabilities Clinic/Center
  • Hialeah, FL
National Provider Identifier
1013683440
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
ARK PROVISION ENTERPRISES, INC.
Practice address
5911 NW 173Rd Dr Unit 11
Hialeah, FL 33015-5122
Phone
(786) 655-9992
Fax
(786) 734-8142
NPI assigned
Aug 17, 2021
Organization subpart
Yes
Parent organization
ARK PROVISION ENTERPRISES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Vicente Chang
Title
VP
Phone
(786) 655-9992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

5911 NW 173Rd Dr Unit 11
Hialeah, FL 33015-5122

Mailing address

17333 NW 62ND PL
Hialeah, FL 33015-4502
Phone (305) 826-3256

National Provider Directory

National Provider Directory
Tax ID family
Ark Provision Enterprises Inc2 organizations share this tax ID, including this one
Part of
Ark Provision Enterprises Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1013683440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17333 NW 62ND PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330154502",
            "telephone_number": "305-826-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 NW 173RD DR UNIT 11",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330155122",
            "telephone_number": "786-655-9992",
            "fax_number": "786-734-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARK PROVISION ENTERPRISES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARK PROVISION ENTERPRISES INC",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "VICENTE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "786-655-9992"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.