NPIMap

Organization Active NPI

Supra Medical Group II, LLC

  • Community/Behavioral Health Agency
  • Miami, FL
National Provider Identifier
1033650221
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SUPRA MEDICAL GROUP II, LLC
Practice address
10300 SW 72ND St Ste 387
Miami, FL 33173-3020
Phone
(305) 200-5210
Fax
(305) 200-5780
NPI assigned
Mar 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Authorized official

Name
Kleydson Neves Da Silva, OWNERNPI 1780299487
Title
Manager
Phone
(786) 205-4515

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

10300 SW 72ND St Ste 387
Miami, FL 33173-3020

Mailing address

10300 Sunset Dr Ste 101
Miami, FL 33173-3038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210721000408 FL Part B Supplier - Clinic/Group Practice 2961805536 Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

10300 Sunset Dr
Ste 178
Miami, FL 33173

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1033650221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SUNSET DR STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 72ND ST STE 387",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733020",
            "telephone_number": "305-200-5210",
            "fax_number": "305-200-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPRA MEDICAL GROUP II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A",
        "authorized_official_last_name": "NEVES DA SILVA",
        "authorized_official_first_name": "KLEYDSON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-205-4515",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral 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
        }
    ],
    "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 May 29, 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.