Medical Superior Group

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

ME66588 Issued in FL

Legal business name

MEDICAL SUPERIOR GROUP

Practice address

434 SW 12TH Ave
Ste 102
Miami, FL 33130-2440

Phone

(305) 563-7914

NPI assigned

Jun 23, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Rafael S Grillo, M.D

Title

President

Phone

(305) 563-7914

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1093197329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 SW 12TH AVE",
            "address_2": "STE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331302440",
            "telephone_number": "305-563-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 SW 12TH AVE",
            "address_2": "STE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331302440",
            "telephone_number": "305-563-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SUPERIOR GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "GRILLO",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-563-7914",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "ME66588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375697100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Miami, FL
• Providers in Miami, FL by specialty
• Health Maintenance Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.