NPIMap

Organization Active NPI

La Colonia Medical Center Inc

  • Health Service Clinic/Center
  • Cutler Bay, FL
National Provider Identifier
1356911556
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
LA COLONIA MEDICAL CENTER INC
Practice address
20841 S Dixie Hwy
Cutler Bay, FL 33189-2217
Phone
(305) 823-3312
Fax
(786) 360-2327
NPI assigned
Jun 29, 2021
Last updated
Jun 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Authorized official

Name
Yenin Acevedo, FMG
Title
President
Phone
(305) 608-1082

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

20841 S Dixie Hwy
Cutler Bay, FL 33189-2217

Mailing address

167 W 23Rd St
Hialeah, FL 33010-2211
Phone (305) 608-1082

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060428000280 FL Part B Supplier - Clinic/Group Practice 2264442607 Receives reassigned benefits from 12 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cutler Bay, FL; Tamarac, FL; Pembroke Pines, FL; North Miami, FL; Naranja, FL; Miami, FL; Hialeah, FL

Other NPIs on the same Medicare enrollment 4

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

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
10D2249084La Colonia Medical Center Inc20841 S Dixie Hwy, Cutler Bay, FL 33189Certificate of waiverJan 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
La Colonia Medical Center15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Networks

  • HealthSun Health Plans Network

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1356911556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 W 23RD ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330102211",
            "telephone_number": "305-608-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20841 S DIXIE HWY",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331892217",
            "telephone_number": "305-823-3312",
            "fax_number": "786-360-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA COLONIA MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "YENIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-608-1082",
        "authorized_official_credential": "FMG"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.