NPIMap

Organization Active NPI

CCRM Florida LLC

  • Ambulatory Surgical Clinic/Center
  • Miami, FL
National Provider Identifier
1306589809
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CCRM FLORIDA LLC
Practice address
19505 Biscayne Blvd
Miami, FL 33180-2314
Phone
(303) 885-5762
NPI assigned
Apr 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Authorized official

Name
Diane Ravech
Title
Chief Managed Care Officer
Phone
(860) 305-6640

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Fertility Facility 261QA0006X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

19505 Biscayne Blvd
Miami, FL 33180-2314

Mailing address

9380 Station St
Lone Tree, CO 80124-6831
Phone (303) 885-5762

Other names 1

  • CCRM Florida Other name

National Provider Directory

National Provider Directory
Tax ID family
CCRM Florida3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1306589809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9380 STATION ST",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801246831",
            "telephone_number": "303-885-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19505 BISCAYNE BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331802314",
            "telephone_number": "303-885-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCRM FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "RAVECH",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CHIEF MANAGED CARE OFFICER",
        "authorized_official_telephone_number": "860-305-6640"
    },
    "taxonomies": [
        {
            "code": "261QA0006X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Fertility Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCRM Florida",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CCRM Florida",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 24, 2025; 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.