Organization Active NPI

Excellence Care Florida LLC

  • Community Health Clinic/Center
  • Doral, FL
National Provider Identifier
1013684992
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
EXCELLENCE CARE FLORIDA LLC
Practice address
4005 NW 114TH Ave Unit 22
Doral, FL 33178-4373
Phone
(786) 366-2050
NPI assigned
Aug 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Ernesto Guevara, PMHNPNPI 1093342818
Title
Ceo/Ambr
Phone
(786) 366-2050

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Community Health Clinic/Center 261QC1500X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

4005 NW 114TH Ave Unit 22
Doral, FL 33178-4373

Mailing address

14113 SW 161St CT
Miami, FL 33196-6543
Phone (786) 366-2050

Other practice location 1

7171 SW 62nd Ave
South Miami, FL 33143-4723
Phone (786) 366-2050

Other practice location 2

1469 NW 36th St
Miami, FL 33142-5557
Phone (786) 366-2050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211012003004 FL Part B Supplier - Clinic/Group Practice 3678971264 Receives reassigned benefits from 10 practitioners
Practice locations: Doral, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2314125Excellence Care Florida LLC4005 NW 114TH Ave, Doral, FL 33178Certificate of waiverNov 13, 2026

National Provider Directory

National Provider Directory

Locations

1469 NW 36th St
Miami, FL 33142
Phone (305) 635-0366

7171 SW 62nd Ave
South Miami, FL 33143
Phone (305) 270-5305

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 10

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": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1013684992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14113 SW 161ST CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331966543",
            "telephone_number": "786-366-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 NW 114TH AVE UNIT 22",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331784373",
            "telephone_number": "786-366-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7171 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "South Miami",
            "state": "FL",
            "postal_code": "331434723",
            "country_code": "US",
            "telephone_number": "786-366-2050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1469 NW 36th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331425557",
            "country_code": "US",
            "telephone_number": "786-366-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXCELLENCE CARE FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "GUEVARA",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_title_or_position": "CEO/AMBR",
        "authorized_official_telephone_number": "786-366-2050",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.