Professional Medical Health Services LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME64856 Issued in FL

Legal business name

PROFESSIONAL MEDICAL HEALTH SERVICES LLC

Practice address

5190 NW 167TH St Ste 104
Miami Lakes, FL 33014-6337

Phone

(786) 955-6598

Fax

(786) 955-6857

NPI assigned

Feb 25, 2008

Organization subpart

No

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

Authorized official

Name

Luis Campillo, M.D.

Title

President

Phone

(786) 955-6598

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1184893034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 NW 167TH ST STE 104",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146337",
            "telephone_number": "786-955-6598",
            "fax_number": "786-955-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 NW 167TH ST STE 104",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146337",
            "telephone_number": "786-955-6598",
            "fax_number": "786-955-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL MEDICAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "CAMPILLO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-955-6598",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME64856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.