SSLD Group Corp

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SSLD GROUP CORP

Practice address

4789 NW 167TH St
Miami Gardens, FL 33055-4242

Phone

(305) 413-3863

NPI assigned

Aug 12, 2025

Organization subpart

No

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

Authorized official

Name

Surafel Kebede Gebreselassie, MDNPI 1912170713

Title

President

Phone

(305) 413-3863

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Surafel Kebede Gebreselassie, M.D.

  • Nephrology Physician
  • Weston, FL
  • NPI 1912170713
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754956800000",
    "number": "1154207678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4789 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330554242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4789 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330554242",
            "telephone_number": "305-413-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSLD GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "GEBRESELASSIE",
        "authorized_official_first_name": "SURAFEL",
        "authorized_official_middle_name": "KEBEDE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-413-3863",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.