Medica One Health LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MEDICA ONE HEALTH LLC

Practice address

10794 Pines Blvd Ste 202
Pembroke Pines, FL 33026-3920

Phone

(954) 589-5958

Fax

(954) 589-5785

NPI assigned

Sep 29, 2022

Organization subpart

No

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

Authorized official

Name

Carlos J Haro, DONPI 1316955388

Title

Primary Physician

Phone

(954) 589-5958

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MEDICA ONE HEALTH LLC Other name

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 2

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

• Carlos J Haro, DO, DAAPM

  • Family Medicine Physician
  • Pembroke Pnes, FL
  • NPI 1316955388
  Medicare reassignment NPD Authorized official
• David Ernesto Simon, APRN

  • Nurse Practitioner
  • Pembroke Pines, FL
  • NPI 1003625062
  NPD (past)

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1285358606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-589-5958",
            "fax_number": "954-589-5785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-589-5958",
            "fax_number": "954-589-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICA ONE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "HARO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRIMARY PHYSICIAN",
        "authorized_official_telephone_number": "954-589-5958",
        "authorized_official_credential": "DO"
    },
    "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": "276279000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICA ONE HEALTH LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, 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 Sep 29, 2022; 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.