NPIMap

Organization Active NPI

La Sagrada Familia Medical Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, FL
National Provider Identifier
1508468869
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LA SAGRADA FAMILIA MEDICAL CENTER INC
Practice address
7270 NW 12TH St Ste 430
Miami, FL 33126-1941
Phone
(786) 615-2843
Fax
(786) 980-1607
NPI assigned
Nov 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Ailen Cruz BergonNPI 1891566295
Title
President
Phone
(786) 615-2843

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

7270 NW 12TH St Ste 430
Miami, FL 33126-1941

Mailing address

7270 NW 12TH St Ste 430
Miami, FL 33126-1941
Phone (786) 615-2843

Other names 1

  • La Sagrada Familia Mental Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211213002415 FL Part B Supplier - Clinic/Group Practice 8224428826 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Miami, FL
O20230727001079 FL Part A Provider - Community Mental Health Center 8224428826 Practice locations: Miami, FL

Community mental health center certification: CCN 684656

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LA SAGRADA FAMILIA MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Community mental health center
Participating since
Jan 30, 2024
Last certification
Jan 30, 2024
Ownership / control type
For profit – individual
Facility address
7270 NW 12TH St Ste 430
Miami, FL 33126

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

9600 NW 25th St
Ste 3C
Doral, FL 33172
Phone (786) 615-2843

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1508468869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7270 NW 12TH ST STE 430",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331261941",
            "telephone_number": "786-615-2843",
            "fax_number": "786-980-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7270 NW 12TH ST STE 430",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331261941",
            "telephone_number": "786-615-2843",
            "fax_number": "786-980-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA SAGRADA FAMILIA MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-12",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "CRUZ BERGON",
        "authorized_official_first_name": "AILEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-615-2843"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Sagrada Familia Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.