Caremax Medical Center of Pembroke Pines, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CAREMAX MEDICAL CENTER OF PEMBROKE PINES, LLC

Practice address

501 NW 103Rd Ave
Pembroke Pines, FL 33026-3924

Phone

(305) 245-3247

Fax

(877) 861-0354

NPI assigned

Jan 31, 2017

Organization subpart

No

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

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Caremax Medical Center of Pembroke Pines, LLC

  • Clinic/Center
  • Pembroke Pines, FL
  • NPI 1346901816

  O20190311002338

  Same enrollment

Tax ID family

Caremax Medical Center of Pembroke Pines LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Caremax Medical Center of Pembroke Pines, LLC

  • Clinic/Center
  • Hialeah, FL
  • NPI 1235890708
  NPD tax ID
• Caremax Medical Center of Pembroke Pines, LLC

  • Clinic/Center
  • Pembroke Pines, FL
  • NPI 1346901816
  NPD tax ID

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Caremax Medical Center of Pembroke Pines, LLC

  • Clinic/Center
  • Hialeah, FL
  • NPI 1235890708
  NPPES parent name
• Caremax Medical Center of Pembroke Pines, LLC

  • Clinic/Center
  • Pembroke Pines, FL
  • NPI 1346901816
  NPPES parent name

Practitioners 3

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

• Elesban Alvero Proenza, ARNP

  • Family Nurse Practitioner
  • Pembroke Pines, FL
  • NPI 1790106805
  Medicare reassignment NPD
• Maria Jussymi Jaime, MD

  • Internal Medicine Physician
  • Homestead, FL
  • NPI 1285874636
  Medicare reassignment NPD
• Ernesto Padron, M.D

  • Family Medicine Physician
  • Pembroke Pines, FL
  • NPI 1295968048
  Medicare reassignment NPD

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1255878005",
    "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": "501 NW 103RD AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263924",
            "telephone_number": "305-245-3247",
            "fax_number": "877-861-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREMAX MEDICAL CENTER OF PEMBROKE PINES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "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": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care MD, LLC
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• Careiq
• Careland Home Health Services Corp
• Caremax Medical Center of Pembroke Pines, LLC
• Caren J Bennett MD PA
• Carenational Clinical Management, LLC
• Carenational Health System, Inc
• Carepatrol of NW Miami-Dade & Greater Ft Lauderdale

• General Practice Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.