Organization Active NPI

Jose M Bermudez MD PA

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1396777645
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOSE M BERMUDEZ MD PA
Practice address
11333 W Flagler St
Miami, FL 33174-1148
Phone
(305) 553-5003
Fax
(305) 553-6156
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Authorized official

Name
Dr. Jose M BermudezNPI 1770508731
Title
President
Phone
(305) 986-5351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X FL Primary

Addresses

Primary practice location

11333 W Flagler St
Miami, FL 33174-1148

Mailing address

16023 SW 43Rd St
Miami, FL 33185-3833
Phone (305) 553-5003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070915000159 FL Part B Supplier - Clinic/Group Practice 5597859967 Receives reassigned benefits from 2 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

11333 W Flagler St
Miami, FL 33174
Phone (305) 553-5003

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1396777645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16023 SW 43RD ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331853833",
            "telephone_number": "305-553-5003",
            "fax_number": "305-553-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11333 W FLAGLER ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331741148",
            "telephone_number": "305-553-5003",
            "fax_number": "305-553-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE M BERMUDEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "BERMUDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-986-5351",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "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 Sep 18, 2014; 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.