NPIMap

Organization Active NPI

Univida Medical Center LLC

  • General Practice Physician
  • Doral, FL
National Provider Identifier
1356068621
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
UNIVIDA MEDICAL CENTER LLC
Practice address
3901 NW 79TH Ave
Doral, FL 33166-6508
Phone
(305) 204-0333
Fax
(305) 359-7546
NPI assigned
Oct 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Luis Castro
Title
Managing Partner
Phone
(305) 204-0333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3901 NW 79TH Ave
Doral, FL 33166-6508

Mailing address

4353 NW 77TH Ave FL 3
Miami, FL 33166-6736
Phone (305) 204-0333

Other identifiers 1

IdentifierTypeStateIssuer
114295506MedicaidFL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2286768Univida Medical Center LLC3901 NW 79TH Ave, Doral, FL 33166Certificate of waiverAug 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Univida Medical Center LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Networks

  • HealthSun Health Plans Network

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1356068621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 NW 77TH AVE FL 3",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331666736",
            "telephone_number": "305-204-0333",
            "fax_number": "305-359-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 NW 79TH AVE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666508",
            "telephone_number": "305-204-0333",
            "fax_number": "305-359-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVIDA MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "CASTRO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "305-204-0333"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114295506",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.