Organization Active NPI

LRB Medical Services P a

  • General Practice Physician
  • Hialeah, FL
National Provider Identifier
1447448592
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME0091458 Issued in FL
Legal business name
LRB MEDICAL SERVICES P A
Practice address
8805 NW 179TH LN
Hialeah, FL 33018-6509
Phone
(305) 300-5501
Fax
(305) 824-3774
NPI assigned
Oct 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Lidia Rosa Bermudez, MDNPI 1730250663
Title
President
Phone
(305) 300-5501

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X ME0091458 FL Primary

Addresses

Primary practice location

8805 NW 179TH LN
Hialeah, FL 33018-6509

Mailing address

8805 NW 179TH LN
Hialeah, FL 33018-6509
Phone (305) 300-5501

Other identifiers 1

IdentifierTypeStateIssuer
68549OtherFLBLUE CROSS BLUE SHIELD FLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050414000966 FL Part B Supplier - Clinic/Group Practice 4587601174 Receives reassigned benefits from 2 practitioners
Practice locations: Hialeah, FL

National Provider Directory

National Provider Directory

Locations

1 W Sample Rd
Ste 301
Deerfield Beach, FL 33064
Phone (954) 320-2889

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": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1447448592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8805 NW 179TH LN",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186509",
            "telephone_number": "305-300-5501",
            "fax_number": "305-824-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8805 NW 179TH LN",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330186509",
            "telephone_number": "305-300-5501",
            "fax_number": "305-824-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LRB MEDICAL SERVICES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "BERMUDEZ",
        "authorized_official_first_name": "LIDIA",
        "authorized_official_middle_name": "ROSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-300-5501",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0091458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FLA",
            "identifier": "68549",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.