NPIMap

Organization Active NPI

Florida Medical Center Group, Inc.

  • Adolescent Medicine (Family Medicine) Physician
  • Miami, FL
National Provider Identifier
1396002929
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
Legal business name
FLORIDA MEDICAL CENTER GROUP, INC.
Practice address
1501 NW 36 St
Miami, FL 33142-9998
Phone
(786) 378-8200
Fax
(305) 907-5299
NPI assigned
Apr 20, 2012
Last updated
Dec 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Authorized official

Name
Mrs. Madelaine Souto
Title
Ceo
Phone
(786) 378-8200

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Research Study Specialist 1744R1102X NU
Family Medicine Physician 207Q00000X NU
Adolescent Medicine (Family Medicine) Physician 207QA0000X NU Primary
Adult Medicine Physician 207QA0505X NU
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU

Addresses

Primary practice location

1501 NW 36 St
Miami, FL 33142-9998

Mailing address

1501 NW 36TH St
Miami, FL 33142-5559
Phone (786) 378-8200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140507001734 FL Part B Supplier - Clinic/Group Practice 6103059662 Receives reassigned benefits from 8 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory
Tax ID family
Florida Medical Center Group Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546214400000",
    "number": "1396002929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NW 36TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331425559",
            "telephone_number": "786-378-8200",
            "fax_number": "305-907-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NW 36 ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331429998",
            "telephone_number": "786-378-8200",
            "fax_number": "305-907-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MEDICAL CENTER GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-20",
        "last_updated": "2018-12-31",
        "status": "A",
        "authorized_official_last_name": "SOUTO",
        "authorized_official_first_name": "MADELAINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-378-8200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Dec 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.