NPIMap

Organization Active NPI

Caremax Medical Centers of Central Florida LLC

  • Clinic/Center
  • Port St Lucie, FL
National Provider Identifier
1225731102
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CAREMAX MEDICAL CENTERS OF CENTRAL FLORIDA LLC
Practice address
11250 SW Village Parkway
Port St Lucie, FL 34987
Phone
(772) 874-3217
Fax
(772) 874-3227
NPI assigned
Mar 22, 2023
Last updated
Aug 13, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CAREMAX MEDICAL CENTERS OF CENTRAL FLORIDA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Carlos De Solo
Title
Chief Executive Officer
Phone
(305) 649-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

11250 SW Village Parkway
Port St Lucie, FL 34987

Mailing address

1000 NW 57TH CT Ste 400
Miami, FL 33126-3292
Phone (305) 649-8100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220701001691 FL Part B Supplier - Clinic/Group Practice 7012397441 Receives reassigned benefits from 24 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tampa, FL; Saint Cloud, FL; Melbourne, FL; Kissimmee, FL; Clermont, FL; Casselberry, FL; Orlando, FL

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Part of
Caremax Medical Centers of Central Florida LLC

Locations

701 E State Road 50
Ste 731C
Clermont, FL 34711
Phone (321) 235-6230

2595 W International Speedway Blvd
Daytona Beach, FL 32114
Phone (386) 252-2138

7208 N Sterling Ave
Ste A
Tampa, FL 33614
Phone (813) 932-6600

4300 Garden St
Titusville, FL 32796
Phone (321) 267-2001

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1225731102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NW 57TH CT STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263292",
            "telephone_number": "305-649-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11250 SW VILLAGE PARKWAY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34987",
            "telephone_number": "772-874-3217",
            "fax_number": "772-874-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREMAX MEDICAL CENTERS OF CENTRAL FLORIDA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAREMAX MEDICAL CENTERS OF CENTRAL FLORIDA LLC",
        "enumeration_date": "2023-03-22",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "DE SOLO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "305-649-8100"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.