Organization Active NPI

Original Healthcare Corp

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1306340294
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
HCC11288 Issued in FL
Legal business name
ORIGINAL HEALTHCARE CORP
Practice address
11981 SW 144TH CT Ste 101
Miami, FL 33186-8652
Phone
(786) 485-3881
Fax
(305) 675-0219
NPI assigned
Mar 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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

Authorized official

Name
Laidy Gutierrez
Title
President
Phone
(786) 485-3881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X HCC11288 FL Primary

Addresses

Primary practice location

11981 SW 144TH CT Ste 101
Miami, FL 33186-8652

Mailing address

11981 SW 144TH CT Ste 101
Miami, FL 33186-8652
Phone (786) 485-3881

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521763200000",
    "number": "1306340294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11981 SW 144TH CT STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331868652",
            "telephone_number": "786-485-3881",
            "fax_number": "305-675-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11981 SW 144TH CT STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331868652",
            "telephone_number": "786-485-3881",
            "fax_number": "305-675-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORIGINAL HEALTHCARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "LAIDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-485-3881"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "HCC11288",
            "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 23, 2018; 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.