Medwin PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MEDWIN PA

Doing business as

Medwin Clinicians

Practice address

4850 W Oakland Park Blvd Ste 224
Lauderdale Lakes, FL 33313-7261

Phone

(786) 214-2001

NPI assigned

Mar 6, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Micah Boaz Edwin, MDNPI 1033430327

Title

President

Phone

(786) 214-2001

Specialties & licenses 1

Addresses

Other names 1

• Medwin Clinicians Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Micah Boaz Obadiah Edwin, MD

  • General Practice Physician
  • Lauderdale Lakes, FL
  • NPI 1033430327
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1275168650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4067",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333384067",
            "telephone_number": "786-214-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 224",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137261",
            "telephone_number": "786-214-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9900 SW 107th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762798",
            "country_code": "US",
            "telephone_number": "305-307-7070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDWIN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-06",
        "last_updated": "2021-04-08",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "EDWIN",
        "authorized_official_first_name": "MICAH",
        "authorized_official_middle_name": "BOAZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-214-2001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medwin Clinicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medwin Clinicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Allan Mendez, PHARM. D
• Natacha Mendez, APRN
• Evangelina Mendiola, ARNP
• Francisco Mercado Gonzalez, MD

• Primary Care Clinic/Center in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.