167TH Street Medical Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

167TH STREET MEDICAL CENTER INC

Practice address

909 N Miami Beach Blvd
Suite 101
North Miami Beach, FL 33162-3712

Phone

(305) 945-1288

Fax

(305) 949-7479

NPI assigned

Jun 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Yukhanan Benjamin, M.D., PH.D

Title

Doctor, Owner

Phone

(305) 945-1288

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Yukhanan Benjamin Doing business as

Locations

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386840189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 N MIAMI BEACH BLVD",
            "address_2": "SUITE 101",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623712",
            "telephone_number": "305-945-1288",
            "fax_number": "305-949-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N MIAMI BEACH BLVD",
            "address_2": "SUITE 101",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623712",
            "telephone_number": "305-945-1288",
            "fax_number": "305-949-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "167TH STREET MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BENJAMIN",
        "authorized_official_first_name": "YUKHANAN",
        "authorized_official_title_or_position": "DOCTOR, OWNER",
        "authorized_official_telephone_number": "305-945-1288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048180700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Yukhanan Benjamin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in North Miami Beach, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.