Mirage Medical Center Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MIRAGE MEDICAL CENTER INC

Practice address

85 Grand Canal Dr Ste 310
Miami, FL 33144-2570

Phone

(305) 264-4375

NPI assigned

Jun 27, 2007

Organization subpart

No

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

Authorized official

Name

Francesco Villalba

Title

President

Phone

(305) 264-4375

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518164342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 GRAND CANAL DR STE 310",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442570",
            "telephone_number": "305-264-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 GRAND CANAL DR STE 310",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442570",
            "telephone_number": "305-264-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAGE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VILLALBA",
        "authorized_official_first_name": "FRANCESCO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-264-4375"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.