Organization Active NPI

Medical Health Services of South Florida

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1316524432
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL HEALTH SERVICES OF SOUTH FLORIDA
Practice address
1401 E 4TH Ave Ste 204
Hialeah, FL 33010-3504
Phone
(305) 885-9999
NPI assigned
Mar 25, 2021
Last updated
Jun 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Authorized official

Name
Douglas Villalba
Title
Administrator
Phone
(786) 290-7428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1401 E 4TH Ave Ste 204
Hialeah, FL 33010-3504

Mailing address

1401 E 4TH Ave Ste 204
Hialeah, FL 33010-3504
Phone (305) 885-9999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210525000150 FL Part B Supplier - Clinic/Group Practice 9931508926 Receives reassigned benefits from 2 practitioners
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

1401 E 4th Ave
Ste 204
Hialeah, FL 33010
Phone (305) 885-9999

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1316524432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 4TH AVE STE 204",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330103504",
            "telephone_number": "305-885-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E 4TH AVE STE 204",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330103504",
            "telephone_number": "305-885-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL HEALTH SERVICES OF SOUTH FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "VILLALBA",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "786-290-7428"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.