NPIMap

Organization Active NPI

Palm Medical Center Little Havana, LLC

  • Clinic/Center
  • Miami, FL
National Provider Identifier
1497271118
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
HCC11110 Issued in FL
Legal business name
PALM MEDICAL CENTER LITTLE HAVANA, LLC
Practice address
2501 SW 8TH St
Miami, FL 33135-3005
Phone
(305) 642-9992
Fax
(305) 442-1198
NPI assigned
Aug 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Mrs. Marlen Morales, JD
Title
Compliance Officer
Phone
(305) 913-9447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X HCC11110 FL Primary

Addresses

Primary practice location

2501 SW 8TH St
Miami, FL 33135-3005

Mailing address

2600 S Douglas Rd Ste 308
Coral Gables, FL 33134-6134
Phone (305) 913-9447

Other identifiers 1

IdentifierTypeStateIssuer
HCC11110OtherFLAGENCY FOR HEALTH CARE ADMINISTRATION LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160818001144 FL Part B Supplier - Clinic/Group Practice 8224323050 Receives reassigned benefits from 72 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Land O Lakes, FL; Plantation, FL; Port Richey, FL; Sebring, FL; Plant City, FL; Spring Hill, FL; Tamarac, FL; Tampa, FL…

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Palm Medical Centers23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 6

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": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1497271118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S DOUGLAS RD STE 308",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346134",
            "telephone_number": "305-913-9447",
            "fax_number": "305-442-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331353005",
            "telephone_number": "305-642-9992",
            "fax_number": "305-442-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM MEDICAL CENTER LITTLE HAVANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-15",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "MARLEN",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "305-913-9447",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "HCC11110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY FOR HEALTH CARE ADMINISTRATION LICENSE NUMBER",
            "identifier": "HCC11110",
            "state": "FL"
        }
    ],
    "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 Jun 16, 2018; 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.