Dynamic Medical Group of Coral Way

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

OS13450 Issued in FL

Legal business name

DYNAMIC MEDICAL GROUP OF CORAL WAY

Practice address

7221 Coral Way Ste 206
Miami, FL 33155-1436

Phone

(786) 355-3771

NPI assigned

Nov 2, 2015

Organization subpart

No

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

Authorized official

Name

Ivan E Bejerano

Title

President

Phone

(786) 479-6165

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1053784975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7221 CORAL WAY STE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551436",
            "telephone_number": "786-355-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7221 CORAL WAY STE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551436",
            "telephone_number": "786-355-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC MEDICAL GROUP OF CORAL WAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "BEJERANO",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-479-6165"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "OS13450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.