Caremax Medical Center of Pembroke Pines, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CAREMAX MEDICAL CENTER OF PEMBROKE PINES, LLC

Practice address

650 NW 180TH Ter Ste 102
Pembroke Pines, FL 33029-2825

Phone

(954) 436-1212

Fax

(954) 435-5444

NPI assigned

Jan 6, 2022

Organization subpart

Yes

Parent organization

CAREMAX MEDICAL CENTER OF PEMBROKE PINES, LLCAs reported in NPPES

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

Authorized official

Name

Carlos De Solo

Title

Chief Executive Officer

Phone

(305) 649-8100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Caremax Medical Center of Pembroke Pines, LLC

  • General Practice Physician
  • Pembroke Pines, FL
  • NPI 1255878005

  O20190311002338

  Same enrollment

Tax ID family

Caremax Medical Center of Pembroke Pines LLC3 organizations share this tax ID, including this one

Part of

Caremax Medical Center of Pembroke Pines LLC

Other organizations with this tax ID 2

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

• Caremax Medical Center of Pembroke Pines, LLC

  • Clinic/Center
  • Hialeah, FL
  • NPI 1235890708
  NPD tax ID
• Caremax Medical Center of Pembroke Pines, LLC

  • General Practice Physician
  • Pembroke Pines, FL
  • NPI 1255878005
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Caremax Medical Center of Pembroke Pines, LLC

  • General Practice Physician
  • Pembroke Pines, FL
  • NPI 1255878005
  NPPES parent name

Practitioners 3

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

• Elesban Alvero Proenza, ARNP

  • Family Nurse Practitioner
  • Pembroke Pines, FL
  • NPI 1790106805
  NPD
• Maria Jussymi Jaime, MD

  • Internal Medicine Physician
  • Homestead, FL
  • NPI 1285874636
  NPD
• Ernesto Padron, M.D

  • Family Medicine Physician
  • Pembroke Pines, FL
  • NPI 1295968048
  NPD

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1346901816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NW 57TH CT STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263292",
            "telephone_number": "305-649-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 NW 180TH TER STE 102",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292825",
            "telephone_number": "954-436-1212",
            "fax_number": "954-435-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREMAX MEDICAL CENTER OF PEMBROKE PINES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAREMAX MEDICAL CENTER OF PEMBROKE PINES, LLC",
        "enumeration_date": "2022-01-06",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "DE SOLO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "305-649-8100"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Care Pharmaceuticals Inc
• Care Response Home Health Agency Corp.
• Careiq
• Careland Home Health Services Corp
• Caremax Medical Center of Pembroke Pines, LLC
• Caren J Bennett MD PA
• Carenational Clinical Management, LLC
• Carenational Health System, Inc
• Carepatrol of NW Miami-Dade & Greater Ft Lauderdale
• Carine Robert

• Clinic/Center in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.