NPIMap

Organization Active NPI

Long Life Medical Inc

  • Medically Fragile Infants and Children Day Care
  • Miami, FL
National Provider Identifier
1316912975
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medically Fragile Infants and Children Day CareTaxonomy code 261QM3000X
License
MCC4499 Issued in FL
Legal business name
LONG LIFE MEDICAL INC
Practice address
2780 SW 87TH Ave
Suite 104
Miami, FL 33165-3296
Phone
(305) 552-7723
Fax
(305) 552-7791
NPI assigned
Feb 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Authorized official

Name
Enrique Fraxedas
Title
President
Phone
(305) 552-7723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medically Fragile Infants and Children Day Care 261QM3000X MCC4499 FL Primary

Addresses

Primary practice location

2780 SW 87TH Ave
Suite 104
Miami, FL 33165-3296

Mailing address

2780 SW 87 Ave
Ste 104
Miami, FL 33165
Phone (305) 552-7723

Other identifiers 1

IdentifierTypeStateIssuer
34637OtherBCBSF

National Provider Directory

National Provider Directory

Locations

2780 SW 87th Ave
Ste 104
Miami, FL 33165
Phone (305) 552-7723

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1316912975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 SW 87 AVE",
            "address_2": "STE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33165",
            "telephone_number": "305-552-7723",
            "fax_number": "305-552-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 SW 87TH AVE",
            "address_2": "SUITE 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653296",
            "telephone_number": "305-552-7723",
            "fax_number": "305-552-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG LIFE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "FRAXEDAS",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-552-7723"
    },
    "taxonomies": [
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": "FL",
            "license": "MCC4499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSF",
            "identifier": "34637",
            "state": null
        }
    ],
    "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 28, 2008; 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.