Med-Source Group LLC.

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

MED-SOURCE GROUP LLC.

Practice address

15476 NW 77TH CT
Miami Lakes, FL 33016-5823

Phone

(786) 443-0873

NPI assigned

Apr 28, 2015

Organization subpart

No

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

Authorized official

Name

Otto J Valdes

Title

Ceo

Phone

(786) 443-0873

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430179200000",
    "number": "1114304144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15476 NW 77TH CT",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165823",
            "telephone_number": "786-443-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15476 NW 77TH CT",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165823",
            "telephone_number": "786-443-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-SOURCE GROUP LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-04-28",
        "status": "A",
        "authorized_official_last_name": "VALDES",
        "authorized_official_first_name": "OTTO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-443-0873"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Me&Y Community Services Corp
• Med Lake Center
• Med Lake Center LLC
• Med Research and Aesthetics LLC
• Med-Pal Home Health Care LLC
• Med-X Medical Equipment Corp.
• Melissa Mederos
• Medi-Pro Home-Care Services, LLC
• Yolanda Medica-Soso
• Medical & Psychiatric Health Research Group of Florida

• Point of Service in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Point of Service in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.