Supra Medical Group II, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SUPRA MEDICAL GROUP II, LLC

Practice address

10300 SW 72ND St Ste 101
Miami, FL 33173-3038

Phone

(305) 200-5210

Fax

(305) 200-5780

NPI assigned

Nov 1, 2021

Organization subpart

No

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

Authorized official

Name

Kleydson Da Silva

Title

Ceo

Phone

(305) 200-5210

Specialties & licenses 4

Addresses

Tax ID family

Supra Medical Group II LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Supra Medical Group II, LLC

  • General Practice Physician
  • Miami, FL
  • NPI 1205592656
  NPD tax ID

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1083379564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 72ND ST STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733038",
            "telephone_number": "305-200-5210",
            "fax_number": "305-200-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 72ND ST STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733038",
            "telephone_number": "305-200-5210",
            "fax_number": "305-200-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPRA MEDICAL GROUP II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "DA SILVA",
        "authorized_official_first_name": "KLEYDSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-200-5210"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Support Care Group, Inc.
• Support Coordinator & Management Services, Inc.
• Supportive Health Services, PLLC
• Supportive Health Systems Corp
• Supra Medical Group II, LLC
• Supra Medical Group II, LLC
• Supreme Alf
• Supreme Care Equipment, Inc
• Supreme Care Equipment, Inc.
• Supreme Care Miami Corp

• Multi-Specialty Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.