NPIMap

Organization Active NPI

South Miami Criticare Inc.

  • Emergency Medicine Physician
  • South Miami, FL
National Provider Identifier
1306878210
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOUTH MIAMI CRITICARE INC.
Practice address
6200 SW 73Rd St
South Miami, FL 33143-4679
Phone
(305) 665-4614
NPI assigned
Jul 7, 2006
Last updated
Mar 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Authorized official

Name
David Tolliver
Title
VP
Phone
(786) 662-5252

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

6200 SW 73Rd St
South Miami, FL 33143-4679

Mailing address

6200 SW 73Rd St
South Miami, FL 33143-4679
Phone (786) 662-5252

Other identifiers 1

IdentifierTypeStateIssuer
255056300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000334 FL Part B Supplier - Clinic/Group Practice 5092629808 Receives reassigned benefits from 171 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

5901 SW 74th St
Ste 204
Miami, FL 33143

Practitioners & affiliated clinicians

Practitioners 195

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 195

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1306878210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SW 73RD ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434679",
            "telephone_number": "786-662-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SW 73RD ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434679",
            "telephone_number": "305-665-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MIAMI CRITICARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "TOLLIVER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "786-662-5252"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255056300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.