NPIMap

Organization Active NPI

My Clinic Integral Medical Center Inc

  • Point of Service
  • Miami, FL
National Provider Identifier
1396180535
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
MA62083 Issued in FL
Legal business name
MY CLINIC INTEGRAL MEDICAL CENTER INC
Practice address
2711 SW 137TH Ave
#93
Miami, FL 33175-6359
Phone
(305) 646-1932
Fax
(305) 967-8106
NPI assigned
May 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Authorized official

Name
Yusdeivys Perez, MA62083
Title
Owner
Phone
(786) 378-0649

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X MA62083 FL Primary

Addresses

Primary practice location

2711 SW 137TH Ave
#93
Miami, FL 33175-6359

Mailing address

2711 SW 137TH Ave
#93
Miami, FL 33175-6359
Phone (305) 646-1932

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1396180535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 SW 137TH AVE",
            "address_2": "#93",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756359",
            "telephone_number": "305-646-1932",
            "fax_number": "305-967-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 SW 137TH AVE",
            "address_2": "#93",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756359",
            "telephone_number": "305-646-1932",
            "fax_number": "305-967-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY CLINIC INTEGRAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "YUSDEIVYS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-378-0649",
        "authorized_official_credential": "MA62083"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "FL",
            "license": "MA62083",
            "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 May 1, 2013; 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.