Medstation Miami Primary Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS9856 Issued in FL

Legal business name

MEDSTATION MIAMI PRIMARY CARE LLC

Practice address

6701 Sunset Dr
Suite # 112
South Miami, FL 33143-4529

Phone

(305) 667-1511

Fax

(305) 503-8955

NPI assigned

Aug 29, 2016

Last updated

Aug 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thierry O. Jacquemin, DO

Title

Manageer Member

Phone

(305) 667-1511

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1548716657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 SUNSET DR",
            "address_2": "SUITE # 112",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434529",
            "telephone_number": "305-667-1511",
            "fax_number": "305-503-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 SUNSET DR",
            "address_2": "SUITE # 112",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434529",
            "telephone_number": "305-667-1511",
            "fax_number": "305-503-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTATION MIAMI PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "JACQUEMIN",
        "authorized_official_first_name": "THIERRY",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "MANAGEER MEMBER",
        "authorized_official_telephone_number": "305-667-1511",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS9856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001536700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1750407086",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marieddy Y Medina
• Yairizet Medina, APRN
• Medlab Diagnostics 2 LLC
• Medlab Diagnostics, LLC (FastLabs)
• Natalya A Medrano, M.D.
• Shahneel Mehmood, M.D.
• Kshitij Mehrotra, MD
• Pokai Mei, D.O.
• Michael Jay Meister,
• Irene Beatriz Mejia Trigueros, RD, LN

• Internal Medicine Physician in South Miami, FL
• Providers in South Miami, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.