Primary Care Specialists of the Palm Beaches LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIMARY CARE SPECIALISTS OF THE PALM BEACHES LLC

Practice address

6101 Blue Lagoon Dr Ste 400
Miami, FL 33126-2051

Phone

(305) 662-5200

Fax

(305) 284-7948

NPI assigned

Nov 27, 2007

Organization subpart

Yes

Parent organization

PRIMARY CARE SPECIALISTS OF THE PALM BEACHES LLCAs reported in NPPES

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

Authorized official

Name

Gemma Rosello

Title

VP

Phone

(305) 500-2000

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Conviva Care Center Doing business as

Part of

Primary Care Specialists of

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Conviva Medical Center Management LLC

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1649324278

  Member Of

  NPD member

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.

• Primary Care Specialists of the Palm Beaches

  • Geriatric Medicine (Family Medicine) Physician
  • West Palm Beach, FL
  • NPI 1780605014
  NPPES parent name

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1265614754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262051",
            "telephone_number": "305-662-5200",
            "fax_number": "305-284-7948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1651 S Congress Ave",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334065903",
            "country_code": "US",
            "telephone_number": "561-966-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIMARY CARE SPECIALISTS OF THE PALM BEACHES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY CARE SPECIALISTS OF THE PALM BEACHES LLC",
        "enumeration_date": "2007-11-27",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "ROSELLO",
        "authorized_official_first_name": "GEMMA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "305-500-2000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012616300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012616302",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012616303",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012616301",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conviva Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Miami, FL
• Providers in Miami, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.