PMC North Shore, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PMC NORTH SHORE, LLC

Doing business as

PMC North Shore

Practice address

1190 NW 95 Street
Suite 310
Miami, FL 33150

Phone

(305) 835-9844

Fax

(305) 835-9851

NPI assigned

Jan 3, 2011

Last updated

Jan 3, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Spencer Angel

Title

Managing Member

Phone

(305) 255-1355

Specialties & licenses 1

Addresses

Other names 1

• PMC North Shore Doing business as

Practitioners 2

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.

• Michel Granados-Ruiz, APRN

  • Family Nurse Practitioner
  • Plantation, FL
  • NPI 1740754720
  NPD (past)
• Alexandra Tracy, APRN

  • Family Nurse Practitioner
  • Tampa, FL
  • NPI 1205118825
  NPD (past)

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1255635454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST",
            "address_2": "SUITE 310",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331502063",
            "telephone_number": "305-835-9844",
            "fax_number": "305-835-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 NW 95 STREET",
            "address_2": "SUITE 310",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33150",
            "telephone_number": "305-835-9844",
            "fax_number": "305-835-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMC NORTH SHORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-03",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "ANGEL",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "305-255-1355"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PMC North Shore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• PMC Jackson South, LLC
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• PMC Medical Center, Inc. (Premier Medical Center)
• PMC Medical Management, LLC
• PMC Mso Management, LLC
• PMC Palmetto Bay Corp.
• PMC Physician Management, LLC
• Pmcme Inc
• PMD Millennium Services Corp
• PMG Professional Medical Group Inc

• Health Service Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.