Organization Active NPI

Medplan Clinic, LLC

  • Clinic/Center
  • Miami Lakes, FL
National Provider Identifier
1023432507
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MEDPLAN CLINIC, LLC
Practice address
13903 NW 67TH Ave Ste 250
Miami Lakes, FL 33014-2938
Phone
(305) 801-6952
NPI assigned
Feb 5, 2014
Last updated
Jun 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Authorized official

Name
Manuel Iglesias
Title
Ceo
Phone
(786) 641-5348

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

13903 NW 67TH Ave Ste 250
Miami Lakes, FL 33014-2938

Mailing address

8750 NW 36TH Street
Suite 300
Doral, FL 33178
Phone (786) 641-5348

Other identifiers 1

IdentifierTypeStateIssuer
018781000MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Medplan Clinic LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497225600000",
    "number": "1023432507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8750 NW 36TH STREET",
            "address_2": "SUITE 300",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "33178",
            "telephone_number": "786-641-5348",
            "fax_number": "305-615-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13903 NW 67TH AVE STE 250",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142938",
            "telephone_number": "305-801-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPLAN CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2017-06-12",
        "status": "A",
        "authorized_official_last_name": "IGLESIAS",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-641-5348"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018781000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.