NPIMap

Organization Active NPI

MCJ Medical Center Corp

  • Clinic/Center
  • Doral, FL
National Provider Identifier
1225075575
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
HCC5974 Issued in FL
Legal business name
MCJ MEDICAL CENTER CORP
Practice address
3900 NW 79TH Ave
Suite 728
Doral, FL 33166-6556
Phone
(305) 468-1714
Fax
(305) 468-1757
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Authorized official

Name
Mr. Igmar Chang
Title
Office Manager
Phone
(305) 468-1714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X HCC5974 FL Primary

Addresses

Primary practice location

3900 NW 79TH Ave
Suite 728
Doral, FL 33166-6556

Mailing address

3900 NW 79TH Ave
Suite 728
Doral, FL 33166-6556
Phone (305) 468-1714

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1225075575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE",
            "address_2": "SUITE 728",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666556",
            "telephone_number": "305-468-1714",
            "fax_number": "305-468-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE",
            "address_2": "SUITE 728",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666556",
            "telephone_number": "305-468-1714",
            "fax_number": "305-468-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCJ MEDICAL CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "IGMAR",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-468-1714",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "HCC5974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 23, 2009; 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.