Organization Active NPI

Mental Care Medical Center Inc

Doing business as Medical C are Center Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Doral, FL
National Provider Identifier
1154932457
Registry record updated Jun 26, 2023
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
MENTAL CARE MEDICAL CENTER INC
Doing business as
Medical C are Center Group
Practice address
7925 NW 12TH St Ste 225
Doral, FL 33126-1821
Phone
(305) 788-6644
NPI assigned
Aug 11, 2020
Last updated
Jun 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Pedro A Amador Rodriguez
Title
Owner/President
Phone
(305) 788-6644

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

7925 NW 12TH St Ste 225
Doral, FL 33126-1821

Mailing address

7925 NW 12TH St Ste 225
Doral, FL 33126-1821
Phone (305) 788-6644

Other practice location 1

7925 NW 12th St Ste 225
Doral, FL 33126-1821
Phone (305) 788-6644

Other identifiers 3

IdentifierTypeStateIssuer
117263400MedicaidFL
107706300MedicaidFL
110034600MedicaidFL

Other names 1

  • Medical C are Center Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211025001858 FL Part B Supplier - Clinic/Group Practice 8224426234 Receives reassigned benefits from 4 practitioners
Practice locations: Doral, FL

National Provider Directory

National Provider Directory

Locations

7925 NW 12th St
Ste 225
Doral, FL 33126
Phone (305) 362-1611

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1154932457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 NW 12TH ST STE 225",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261821",
            "telephone_number": "305-788-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 NW 12TH ST STE 225",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261821",
            "telephone_number": "305-788-6644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7925 NW 12th St Ste 225",
            "address_purpose": "LOCATION",
            "city": "Doral",
            "state": "FL",
            "postal_code": "331261821",
            "country_code": "US",
            "telephone_number": "305-788-6644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MENTAL CARE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "AMADOR RODRIGUEZ",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "305-788-6644"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117263400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107706300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110034600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical C are Center Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.