NPIMap

Organization Active NPI

Innovation Medical Center Inc

  • Clinic/Center
  • Hialeah, FL
National Provider Identifier
1245673763
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MA32226 Issued in FL
Legal business name
INNOVATION MEDICAL CENTER INC
Practice address
1140 W 50TH St
302
Hialeah, FL 33012-3440
Phone
(786) 305-4466
NPI assigned
Apr 15, 2013
Last updated
Apr 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Authorized official

Name
Elcida Lopez, LMT
Title
President
Phone
(786) 305-4466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MA32226 FL Primary

Addresses

Primary practice location

1140 W 50TH St
302
Hialeah, FL 33012-3440

Mailing address

1140 W 50TH St
302
Hialeah, FL 33012-3440
Phone (786) 305-4466

Other identifiers 1

IdentifierTypeStateIssuer
MA32226OtherFLPROFESSIONAL LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365984000000",
    "number": "1245673763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W 50TH ST",
            "address_2": "302",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123440",
            "telephone_number": "786-305-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W 50TH ST",
            "address_2": "302",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123440",
            "telephone_number": "786-305-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-15",
        "last_updated": "2013-04-15",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ELCIDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-305-4466",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "MA32226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "MA32226",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.