NPIMap

Organization Active NPI

Blue Clinical Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, FL
National Provider Identifier
1093590242
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BLUE CLINICAL CENTER LLC
Practice address
8370 W Flagler St Ste 232
Miami, FL 33144-2040
Phone
(786) 663-2822
NPI assigned
Aug 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Authorized official

Name
Alexandra Codecido
Title
Owner
Phone
(786) 663-2822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

8370 W Flagler St Ste 232
Miami, FL 33144-2040

Mailing address

8370 W Flagler St Ste 232
Miami, FL 33144-2040
Phone (786) 663-2822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231010001296 FL Part B Supplier - Clinic/Group Practice 1759736846 Receives reassigned benefits from 7 practitioners
Practice locations: Fort Myers, FL; Miami, FL

National Provider Directory

National Provider Directory
Tax ID family
Blue Clinical Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

10300 Sunset Dr
Ste 261D
Miami, FL 33173
Phone (786) 327-3694

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1093590242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8370 W FLAGLER ST STE 232",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442040",
            "telephone_number": "786-663-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8370 W FLAGLER ST STE 232",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442040",
            "telephone_number": "786-663-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE CLINICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "CODECIDO",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-663-2822"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.