NPIMap

Organization Active NPI

Caremax Medical Center of Broward LLC

  • Clinic/Center
  • Plantation, FL
National Provider Identifier
1508569849
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CAREMAX MEDICAL CENTER OF BROWARD LLC
Practice address
4302 W Broward Blvd
Plantation, FL 33317-3780
Phone
(954) 644-8902
Fax
(877) 967-5710
NPI assigned
Mar 24, 2023
Organization subpart
Yes
Parent organization
CAREMAX MEDICAL CENTER OF BROWARD LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Carlos De Solo
Title
Chief Executive Officer
Phone
(305) 649-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4302 W Broward Blvd
Plantation, FL 33317-3780

Mailing address

1000 NW 57TH CT Ste 400
Miami, FL 33126-3292
Phone (305) 649-8100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160411001049 FL Part B Supplier - Clinic/Group Practice 5496053340 Receives reassigned benefits from 7 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Deerfield Beach, FL; Fort Lauderdale, FL; Plantation, FL; Pompano Beach, FL

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Caremax Medical Center of Broward LLC6 organizations share this tax ID, including this one
Part of
Caremax Medical Center of Broward LLC

Other organizations with this tax ID 5

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

Locations

4302 W Broward Blvd
Plantation, FL 33317
Phone (954) 644-8902

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1679616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1508569849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NW 57TH CT STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263292",
            "telephone_number": "305-649-8100",
            "fax_number": "877-967-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333173780",
            "telephone_number": "954-644-8902",
            "fax_number": "877-967-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREMAX MEDICAL CENTER OF BROWARD LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAREMAX MEDICAL CENTER OF BROWARD LLC",
        "enumeration_date": "2023-03-24",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "DE SOLO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "305-649-8100"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.