NPIMap

Organization Active NPI

125TH Street NM Corp

  • Multi-Specialty Clinic/Center
  • North Miami, FL
National Provider Identifier
1255633046
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
PMC20 Issued in FL
Legal business name
125TH STREET NM CORP
Practice address
505 NE 125TH St
North Miami, FL 33161-4718
Phone
(786) 235-7240
Fax
(786) 235-7241
NPI assigned
Nov 30, 2010
Last updated
Nov 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Mr. Igor Niznik
Title
President/Owner
Phone
(786) 235-7240

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X PMC20 FL Primary

Addresses

Primary practice location

505 NE 125TH St
North Miami, FL 33161-4718

Mailing address

505 NE 125TH St
North Miami, FL 33161-4718
Phone (786) 235-7240

Other names 1

  • 125th Street Medical and Urgent Care Center Other name

National Provider Directory

National Provider Directory
Tax ID family
125TH Street NM Corp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1255633046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331614718",
            "telephone_number": "786-235-7240",
            "fax_number": "786-235-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331614718",
            "telephone_number": "786-235-7240",
            "fax_number": "786-235-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "125TH STREET NM CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "NIZNIK",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "786-235-7240",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "PMC20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "125th Street Medical and Urgent Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.