NPIMap

Organization Active NPI

Mdvip Medical Group Holdings, LLC

  • Internal Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1568817799
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MDVIP MEDICAL GROUP HOLDINGS, LLC
Practice address
4950 Communication Ave
Suite 100
Boca Raton, FL 33431-3307
Phone
(561) 982-4300
NPI assigned
Apr 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Authorized official

Name
Dr. Andrea Klemes, D.O.
Title
Chief Medical Officer
Phone
(561) 982-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4950 Communication Ave
Suite 100
Boca Raton, FL 33431-3307

Mailing address

4950 Communication Ave
Suite 100
Boca Raton, FL 33431-3307
Phone (561) 982-4300

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1568817799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 COMMUNICATION AVE",
            "address_2": "SUITE 100",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334313307",
            "telephone_number": "561-982-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 COMMUNICATION AVE",
            "address_2": "SUITE 100",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334313307",
            "telephone_number": "561-982-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDVIP MEDICAL GROUP HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "KLEMES",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "561-982-4300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.