M a Medical Center Corp

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

HCC6842 Issued in FL

Legal business name

M A MEDICAL CENTER CORP

Practice address

5450 S State Road 7
Bay 3
Davie, FL 33314-6442

Phone

(954) 316-8496

Fax

(954) 316-8497

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mario J. Hernandez

Title

President Owner

Phone

(954) 316-8496

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1386665438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 S STATE ROAD 7",
            "address_2": "BAY 3",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333146442",
            "telephone_number": "954-316-8496",
            "fax_number": "954-316-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 S STATE ROAD 7",
            "address_2": "BAY 3",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333146442",
            "telephone_number": "954-316-8496",
            "fax_number": "954-316-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M A MEDICAL CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "954-316-8496",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "HCC6842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA LICENSE",
            "identifier": "HCC6842",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Davie, FL
• Providers in Davie, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.