NPIMap

Organization Active NPI

Independent Medical Group, LLC.

  • Health Service Clinic/Center
  • Plantation, FL
National Provider Identifier
1083205231
Registry record updated Jan 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
INDEPENDENT MEDICAL GROUP, LLC.
Practice address
4101 S Hospital Drive Suite 2
Plantation, FL 33317
Phone
(407) 314-7492
Fax
(833) 253-4230
NPI assigned
Jan 31, 2021
Organization subpart
Yes
Parent organization
IMG PLANTATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 31, 2021

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

Authorized official

Name
Sonia N Torres
Title
Clinical Operations Manager
Phone
(407) 505-6435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

4101 S Hospital Drive Suite 2
Plantation, FL 33317

Mailing address

4101 S Hospital Drive Suite 2
Plantation, FL 33317
Phone (407) 314-7492

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.imghealthclinic.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Independent Medical Group LLC13 organizations share this tax ID, including this one
Part of
Independent Medical Group LLC

Other organizations with this tax ID 12

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": "1612051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612051200000",
    "number": "1083205231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 S HOSPITAL DRIVE SUITE 2",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33317",
            "telephone_number": "407-314-7492",
            "fax_number": "833-253-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 S HOSPITAL DRIVE SUITE 2",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33317",
            "telephone_number": "407-314-7492",
            "fax_number": "833-253-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT MEDICAL GROUP, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMG PLANTATION",
        "enumeration_date": "2021-01-31",
        "last_updated": "2021-01-31",
        "certification_date": "2021-01-31",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "SONIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CLINICAL OPERATIONS MANAGER",
        "authorized_official_telephone_number": "407-505-6435"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.imghealthclinic.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4101 S Hospital Drive Suite 2",
            "city": "Plantation",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2021; 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.