Premier Value Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PREMIER VALUE FAMILY MEDICINE LLC

Practice address

8352 SW 40 Street
Miami, FL 33155-3354

Phone

(305) 225-0707

Fax

(888) 208-1644

NPI assigned

Aug 30, 2013

Organization subpart

No

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

Authorized official

Name

Idaylis Morono-Ponce, MDNPI 1932221561

Title

Physician/President

Phone

(305) 225-0707

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Idaylis Morono Ponce, PHYSICIAN/MD

  • Family Medicine Physician
  • Miami, FL
  • NPI 1932221561
  Medicare reassignment Care Compare group NPD Authorized official
• Yusel Martin Pacheco, APRN

  • Nurse Practitioner
  • Miami, FL
  • NPI 1588377337

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1487088050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8352 SW 40 STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553354",
            "telephone_number": "305-225-0707",
            "fax_number": "888-208-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8352 SW 40 STREET",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553354",
            "telephone_number": "305-225-0707",
            "fax_number": "888-208-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER VALUE FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-30",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "MORONO-PONCE",
        "authorized_official_first_name": "IDAYLIS",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "305-225-0707",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Miami, FL
• Providers in Miami, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.