Kyrillos Medical Care LLC.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

ME96596 Issued in FL

Legal business name

KYRILLOS MEDICAL CARE LLC.

Practice address

170 NE 2ND St
# 23
Boca Raton, FL 33429-5001

Phone

(561) 322-6547

NPI assigned

Mar 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Sara WahbaNPI 1902980642

Title

Owner

Phone

(561) 322-6547

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.

• Sara Wahba, MD

  • Family Medicine Physician
  • Boca Raton, FL
  • NPI 1902980642

  Geriatric Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444348800000",
    "number": "1184017535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 NE 2ND ST",
            "address_2": "# 23",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334295001",
            "telephone_number": "561-322-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 NE 2ND ST",
            "address_2": "# 23",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334295001",
            "telephone_number": "561-322-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYRILLOS MEDICAL CARE LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-10-09",
        "status": "A",
        "authorized_official_last_name": "WAHBA",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-322-6547",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME96596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Geriatric Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.