NPIMap

Organization Active NPI

Suramed Health Center, PA

  • Pediatrics Physician
  • West Palm Beach, FL
National Provider Identifier
1083910632
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME98652 Issued in FL
Legal business name
SURAMED HEALTH CENTER, PA
Practice address
2640 Forest Hill Blvd
West Palm Beach, FL 33406-5931
Phone
(561) 275-7100
Fax
(561) 275-7199
NPI assigned
Jan 31, 2011
Last updated
Dec 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Dr. Alfonso J Henriquez, M.D.NPI 1851449995
Title
Pediatrician
Phone
(561) 275-7100

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME98652 FL Primary

Addresses

Primary practice location

2640 Forest Hill Blvd
West Palm Beach, FL 33406-5931

Mailing address

2640 Forest Hill Blvd
West Palm Beach, FL 33406-5931
Phone (561) 275-7100

Other practice location 1

3255 Forest Hill Blvd Ste 107
West Palm Beach, FL 33406-5854
Phone (561) 275-7100

Other identifiers 1

IdentifierTypeStateIssuer
009406900MedicaidFL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2020429Suramed Health Center PA2640 Forest Hill Blvd, Palm Springs, FL 33406Certificate of waiverFeb 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Suramed Health Center PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

3255 Forest Hill Blvd
#107
West Palm Beach, FL 33406
Phone (561) 275-7100

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1083910632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 FOREST HILL BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065931",
            "telephone_number": "561-275-7100",
            "fax_number": "561-275-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 FOREST HILL BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065931",
            "telephone_number": "561-275-7100",
            "fax_number": "561-275-7199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3255 Forest Hill Blvd Ste 107",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334065854",
            "country_code": "US",
            "telephone_number": "561-275-7100",
            "fax_number": "561-275-7199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SURAMED HEALTH CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-31",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "HENRIQUEZ",
        "authorized_official_first_name": "ALFONSO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "561-275-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME98652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009406900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.