NPIMap

Organization Active NPI

San Miguel Community Wellness Center

  • Physical Therapist
  • Miami, FL
National Provider Identifier
1356128771
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SAN MIGUEL COMMUNITY WELLNESS CENTER
Practice address
12030 SW 129TH CT Ste 107-108
Miami, FL 33186-4583
Phone
(305) 432-4032
NPI assigned
Sep 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Miguel Novoa
Title
President
Phone
(305) 432-4032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

12030 SW 129TH CT Ste 107-108
Miami, FL 33186-4583

Mailing address

12030 SW 129TH CT Ste 107-108
Miami, FL 33186-4583

National Provider Directory

National Provider Directory
Tax ID family
San Miguel Community Wellness Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

12030 SW 129th Ct
Ste 107108
Miami, FL 33186
Phone (305) 432-4032

Practitioners & affiliated clinicians

Practitioners 2

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": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1356128771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12030 SW 129TH CT STE 107-108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12030 SW 129TH CT STE 107-108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864583",
            "telephone_number": "305-432-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MIGUEL COMMUNITY WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-10",
        "status": "A",
        "authorized_official_last_name": "NOVOA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-432-4032"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 11, 2023; 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.