Provider Associates Ipa

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PROVIDER ASSOCIATES IPA

Practice address

25865 SW 139TH Path
Homestead, FL 33032-6696

Phone

(305) 606-6494

NPI assigned

Apr 6, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Luis De Lamar

Title

Ceo

Phone

(305) 606-6494

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1124713045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25865 SW 139TH PATH",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330326696",
            "telephone_number": "305-606-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25865 SW 139TH PATH",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330326696",
            "telephone_number": "305-606-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER ASSOCIATES IPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "DE LAMAR",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-606-6494",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Homestead, FL
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.