Organization Active NPI

Ultimate Diagnostic Center Corp

  • Multi-Specialty Clinic/Center
  • Homestead, FL
National Provider Identifier
1457678526
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ULTIMATE DIAGNOSTIC CENTER CORP
Practice address
28870 S Dixie Hwy
Homestead, FL 33033-2405
Phone
(305) 393-8102
Fax
(305) 359-3689
NPI assigned
Apr 28, 2010
Last updated
Mar 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Authorized official

Name
Jelliezet Orozco
Title
President
Phone
(305) 393-8102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

28870 S Dixie Hwy
Homestead, FL 33033-2405

Mailing address

28870 S Dixie Hwy
Homestead, FL 33033-2405
Phone (305) 393-8102

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110314000219 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6709068620 Practice locations: Homestead, FL

National Provider Directory

National Provider Directory
Tax ID family
Ultimate Diagnostic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

18901 SW 106th Ave
Ste 105A
Cutler Bay, FL 33157
Phone (305) 393-8102

10740 W Flagler St
Ste 9
Miami, FL 33174
Phone (305) 554-4459

Practitioners & affiliated clinicians

Practitioners 4

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": "1272412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1457678526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28870 S DIXIE HWY",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330332405",
            "telephone_number": "305-393-8102",
            "fax_number": "305-359-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28870 S DIXIE HWY",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330332405",
            "telephone_number": "305-393-8102",
            "fax_number": "305-359-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE DIAGNOSTIC CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-28",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "OROZCO",
        "authorized_official_first_name": "JELLIEZET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-393-8102"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.