Organization Active NPI

Abba Medical Group LLC

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1285499145
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ABBA MEDICAL GROUP LLC
Practice address
11420 N Kendall Dr Ste 110
Miami, FL 33176-1039
Phone
(786) 353-2536
Fax
(786) 353-2521
NPI assigned
Feb 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Jorge Enrique Fernandez Ramirez, MD
Title
Owner/Medical Doctor
Phone
(786) 353-2536

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

11420 N Kendall Dr Ste 110
Miami, FL 33176-1039

Mailing address

11420 N Kendall Dr Ste 110
Miami, FL 33176-1039
Phone (786) 353-2536

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2294663Abba Medical Group LLC11420 N Kendall Dr Suite 110, Miami, FL 33176Certificate of waiverNov 28, 2027

National Provider Directory

National Provider Directory

Locations

11420 N Kendall Dr
Ste 110
Miami, FL 33176
Phone (786) 353-2536

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1285499145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11420 N KENDALL DR STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761039",
            "telephone_number": "786-353-2536",
            "fax_number": "786-353-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11420 N KENDALL DR STE 110",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761039",
            "telephone_number": "786-353-2536",
            "fax_number": "786-353-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ RAMIREZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "ENRIQUE",
        "authorized_official_title_or_position": "OWNER/MEDICAL DOCTOR",
        "authorized_official_telephone_number": "786-353-2536",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.