FMD Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME88547 Issued in FL

Legal business name

FMD MEDICAL CORPORATION

Practice address

3659 S Miami Ave Ste 5005
Miami, FL 33133-4221

Phone

(305) 854-2899

Fax

(305) 859-9677

NPI assigned

Dec 5, 2012

Organization subpart

No

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

Authorized official

Name

Ileana Roca

Title

Business Manager

Phone

(305) 854-2899

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1215272026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3659 S MIAMI AVE STE 5005",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334221",
            "telephone_number": "305-854-2899",
            "fax_number": "305-859-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3659 S MIAMI AVE STE 5005",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334221",
            "telephone_number": "305-854-2899",
            "fax_number": "305-859-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "ROCA",
        "authorized_official_first_name": "ILEANA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "305-854-2899"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME88547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Miami, FL
• Providers in Miami, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.