NPIMap

Organization Active NPI

South Dade Primary Care, LLC

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1285748285
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTH DADE PRIMARY CARE, LLC
Practice address
1000 NW 57TH CT Ste 400
Miami, FL 33126-3292
Phone
(786) 239-5791
NPI assigned
Aug 18, 2006
Reactivated
May 10, 2023
Organization subpart
Yes
Parent organization
CLAREMEDICA HEALTH PARTNERS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Mark L Mullinix, AUTHORIZED OFFICIAL
Title
Chief Executive Officer
Phone
(786) 758-3135

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

1000 NW 57TH CT Ste 400
Miami, FL 33126-3292

Mailing address

1000 NW 57TH CT Ste 400
Miami, FL 33126-3292
Phone (786) 239-5791

Other practice location 1

7108 N Nebraska Ave
Tampa, FL 33604-4915
Phone (813) 239-3262

Other practice location 2

8004 N Armenia Ave
Tampa, FL 33604-2763
Phone (813) 933-9131

Other practice location 3

12294 Indian Rocks Rd
Largo, FL 33774-3001
Phone (727) 595-2534

Other practice location 4

9835 E Hibiscus St
Palmetto Bay, FL 33157-5406
Phone (305) 238-8561

Other practice location 5

1500 E Hillsboro Blvd Ste 210
Deerfield Beach, FL 33441-4348
Phone (954) 419-9632

Other practice location 6

1190 NW 95th St Ste 310
Miami, FL 33150-2067
Phone (305) 835-9844

Other practice location 7

1806 N Pine Island Rd
Plantation, FL 33322-5202
Phone (954) 474-0110

Other practice location 8

3345 Burns Rd Ste 302
Palm Beach Gardens, FL 33410-4321
Phone (561) 622-7661

Other practice location 9

4700 N Habana Ave Ste 403
Tampa, FL 33614-7119
Phone (813) 876-9553

Other practice location 10

11211 SW 152nd St
Miami, FL 33157-1101
Phone (305) 255-1355

Other practice location 11

15335 SW 288th St
Homestead, FL 33033-1356
Phone (305) 248-3814

Other identifiers 9

IdentifierTypeStateIssuer
01-02953OtherUNITED HEALTHCARE
01-02956OtherUNITED HEALTHCARE
4347956OtherAETNA INSURANCE
71520OtherBLUE CROSS BLUE SHIELD FL
79328OtherBLEU CROSS BLUE SHIELD FL
005597OtherNEIGHBORHOOD HEALTH PARTN
4497709OtherAETNA INSURANCE
15296OtherAETNA INSURANCE
15313OtherAETNA INSURANCE

Other names 1

  • CLAREMEDICA VIKING OF NORTH FLORIDA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051116000041 FL Part B Supplier - Clinic/Group Practice 6002835360 Receives reassigned benefits from 46 practitioners
Practice locations: Homestead, FL; Largo, FL; Miami, FL; Palm Beach Gardens, FL; Palmetto Bay, FL; Plantation, FL; Tampa, FL; Deerfield Beach, FL

National Provider Directory

National Provider Directory

Locations

12294 Indian Rocks Rd
Ste 100
Largo, FL 33774
Phone (727) 595-2534

13550 SW 120th St
Ste 502
Miami, FL 33186

11211 SW 152nd St
Miami, FL 33157
Phone (305) 255-1355

1190 NW 95th St
Ste 310
Miami, FL 33150
Phone (305) 754-3119

9635 SW 181st Ter
Palmetto Bay, FL 33157
Phone (305) 238-8561

5901 SW 74th St
Ste 205
South Miami, FL 33143
Phone (305) 666-8691

13701 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 872-0897

13701 Bruce B Downs Blvd
Ste 106
Tampa, FL 33613
Phone (813) 632-8861

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15805/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 52

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

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1285748285",
    "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": "786-239-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NW 57TH CT STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263292",
            "telephone_number": "786-239-5791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7108 N Nebraska Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336044915",
            "country_code": "US",
            "telephone_number": "813-239-3262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8004 N Armenia Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336042763",
            "country_code": "US",
            "telephone_number": "813-933-9131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12294 Indian Rocks Rd",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337743001",
            "country_code": "US",
            "telephone_number": "727-595-2534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9835 E Hibiscus St",
            "address_purpose": "LOCATION",
            "city": "Palmetto Bay",
            "state": "FL",
            "postal_code": "331575406",
            "country_code": "US",
            "telephone_number": "305-238-8561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 E Hillsboro Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334414348",
            "country_code": "US",
            "telephone_number": "954-419-9632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1190 NW 95th St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331502067",
            "country_code": "US",
            "telephone_number": "305-835-9844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1806 N Pine Island Rd",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333225202",
            "country_code": "US",
            "telephone_number": "954-474-0110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3345 Burns Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334104321",
            "country_code": "US",
            "telephone_number": "561-622-7661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 N Habana Ave Ste 403",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336147119",
            "country_code": "US",
            "telephone_number": "813-876-9553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11211 SW 152nd St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331571101",
            "country_code": "US",
            "telephone_number": "305-255-1355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15335 SW 288th St",
            "address_purpose": "LOCATION",
            "city": "Homestead",
            "state": "FL",
            "postal_code": "330331356",
            "country_code": "US",
            "telephone_number": "305-248-3814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH DADE PRIMARY CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAREMEDICA HEALTH PARTNERS, LLC",
        "enumeration_date": "2006-08-18",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "deactivation_date": "2023-04-26",
        "reactivation_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "MULLINIX",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "786-758-3135",
        "authorized_official_credential": "AUTHORIZED OFFICIAL"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "01-02953",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "01-02956",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "4347956",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "71520",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLEU CROSS BLUE SHIELD FL",
            "identifier": "79328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PARTN",
            "identifier": "005597",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "4497709",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "15296",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "15313",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLAREMEDICA VIKING OF NORTH FLORIDA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 10, 2026; 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.