Organization Active NPI

Integrated Specialty Alliance LLC

  • Preferred Provider Organization
  • Miami Lakes, FL
National Provider Identifier
1548035322
Registry record updated Oct 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
INTEGRATED SPECIALTY ALLIANCE LLC
Practice address
14400 NW 77TH CT Ste 306
Miami Lakes, FL 33016-1592
Phone
(770) 810-3796
Fax
(770) 810-3789
NPI assigned
Nov 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2025

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

Authorized official

Name
Debbie Shumake
Title
Coo
Phone
(770) 810-3796

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X Primary

Addresses

Primary practice location

14400 NW 77TH CT Ste 306
Miami Lakes, FL 33016-1592

Mailing address

14400 NW 77TH CT Ste 301
Miami Lakes, FL 33016-1592
Phone (770) 810-3796

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241115000485 FL Part B Supplier - Clinic/Group Practice 6406380237 Receives reassigned benefits from 1 practitioner
Practice locations: Miami Lakes, FL

National Provider Directory

National Provider Directory

Locations

14400 NW 77th Ct
Ste 306
Miami Lakes, FL 33016
Phone (305) 653-5155

14400 NW 77th Ct
Ste 301
Miami Lakes, FL 33016
Phone (770) 810-3796

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760745600000",
    "number": "1548035322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14400 NW 77TH CT STE 301",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161592",
            "telephone_number": "770-810-3796",
            "fax_number": "770-810-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14400 NW 77TH CT STE 306",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161592",
            "telephone_number": "770-810-3796",
            "fax_number": "770-810-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED SPECIALTY ALLIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-21",
        "last_updated": "2025-10-18",
        "certification_date": "2025-10-18",
        "status": "A",
        "authorized_official_last_name": "SHUMAKE",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-810-3796"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2025; 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.