Active NPI
Ultimate Medical Center & Spa LLC
- General Practice Physician
- Miami, FL
National Provider Identifier
1023663259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- ULTIMATE MEDICAL CENTER & SPA LLC
- Practice address
- 12700 SW 128TH St Ste 205
Miami, FL 33186-5378 - Phone
- (305) 278-7579
- Fax
- (305) 278-7589
- NPI assigned
- Aug 5, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Caridad Fonte Estevez
- Title
- Owner
- Phone
- (305) 278-7579
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
12700 SW 128TH St Ste 205
Miami, FL 33186-5378
Mailing address
12700 SW 128TH St Ste 205
Miami, FL 33186-5378
Phone (305) 278-7579
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2172743 | Ultimate Medical Center & Spa, LLC | Certificate of waiver | Oct 9, 2026 |
National Provider Directory
National Provider DirectoryLocations
12700 SW 128th St
Ste 205
Miami, FL 33186
Phone (305) 278-7579
Networks
- HealthSun Health Plans Network
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Legal Medicine
- Miami, FL
- NPI 1336120708
-
- General Practice Physician
- Miami, FL
- NPI 1215940747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1564963200000",
"number": "1023663259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12700 SW 128TH ST STE 205",
"city": "MIAMI",
"state": "FL",
"postal_code": "331865378",
"telephone_number": "305-278-7579",
"fax_number": "305-278-7589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12700 SW 128TH ST STE 205",
"city": "MIAMI",
"state": "FL",
"postal_code": "331865378",
"telephone_number": "305-278-7579",
"fax_number": "305-278-7589"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ULTIMATE MEDICAL CENTER & SPA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-05",
"last_updated": "2019-08-05",
"status": "A",
"authorized_official_last_name": "FONTE ESTEVEZ",
"authorized_official_first_name": "CARIDAD",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "305-278-7579"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"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 Aug 5, 2019; 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.