Active NPI
Grisel Mac Williams MD PA
- Internal Medicine Physician
- Hialeah, FL
National Provider Identifier
1083910202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- GRISEL MAC WILLIAMS MD PA
- Practice address
- 810 E 39TH PL
Hialeah, FL 33013-2863 - Phone
- (305) 691-7018
- Fax
- (305) 691-5814
- NPI assigned
- Feb 5, 2011
- 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
- Michel Diaz
- Title
- Office Manager
- Phone
- (305) 691-7018
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
810 E 39TH PL
Hialeah, FL 33013-2863
Mailing address
810 E 39TH PL
Hialeah, FL 33013-2863
Phone (305) 691-7018
Other practice location 1
18044 NW 6th St Ste 101
Pembroke Pines, FL 33029-2824
Phone (954) 885-9904
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 047895400 | Medicaid | FL |
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 |
|---|---|---|---|
| 10D2063191 | Grisel Mac Williams MD PA | Certificate of waiver | Jul 28, 2027 |
National Provider Directory
National Provider DirectoryLocations
810 E 39th Pl
Hialeah, FL 33013
Phone (305) 691-7018
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Pembroke Pines, FL
- NPI 1083094700
-
- Physician Assistant
- Hialeah, FL
- NPI 1588005797
-
- Family Nurse Practitioner
- Hialeah, FL
- NPI 1891240370
-
- Physician Assistant
- Miami Lakes, FL
- NPI 1902835366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296864000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712016000000",
"number": "1083910202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 E 39TH PL",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330132863",
"telephone_number": "305-691-7018",
"fax_number": "305-691-5814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 E 39TH PL",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330132863",
"telephone_number": "305-691-7018",
"fax_number": "305-691-5814"
}
],
"practiceLocations": [
{
"address_1": "18044 NW 6th St Ste 101",
"address_purpose": "LOCATION",
"city": "Pembroke Pines",
"state": "FL",
"postal_code": "330292824",
"country_code": "US",
"telephone_number": "954-885-9904",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "GRISEL MAC WILLIAMS MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2011-02-05",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A",
"authorized_official_last_name": "DIAZ",
"authorized_official_first_name": "MICHEL",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "305-691-7018"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "047895400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.