NPIMap

Organization Active NPI

Adult & Geriatric Center of South Florida, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Sunrise, FL
National Provider Identifier
1558618488
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
ADULT & GERIATRIC CENTER OF SOUTH FLORIDA, LLC
Practice address
4399 N Nob Hill Rd
Sunrise, FL 33351-5813
Phone
(954) 799-6900
NPI assigned
Aug 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Authorized official

Name
Mr. Mario Galdames Sr., MDNPI 1831391259
Title
President
Phone
(954) 255-7310

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X FL Primary

Addresses

Primary practice location

4399 N Nob Hill Rd
Sunrise, FL 33351-5813

Mailing address

PO Box 970659
Coconut Creek, FL 33097-1201
Phone (954) 799-6900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130307000268 FL Part B Supplier - Clinic/Group Practice 7719132299 Receives reassigned benefits from 12 practitioners
Practice locations: Tamarac, FL; Sunrise, FL; Plantation, FL; Lauderhill, FL; Margate, FL; Coral Springs, FL; Deerfield Beach, FL; Lauderdale Lakes, FL

National Provider Directory

National Provider Directory

Locations

2901 Coral Hills Dr
Ste 360
Coral Springs, FL 33065
Phone (954) 255-7310

8251 W Broward Blvd
Ste 103
Plantation, FL 33324
Phone (954) 255-7310

201 NW 82nd Ave
Ste 105
Plantation, FL 33324
Phone (754) 200-1617

Practitioners & affiliated clinicians

Practitioners 12

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": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1558618488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970659",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330971201",
            "telephone_number": "954-799-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4399 N NOB HILL RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333515813",
            "telephone_number": "954-799-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT & GERIATRIC CENTER OF SOUTH FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "GALDAMES",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-255-7310",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.