125TH Street NM Corp

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

PMC 20 Issued in FL

Legal business name

125TH STREET NM CORP

Practice address

505 NE 125TH St
North Miami, FL 33161-4718

Phone

(786) 235-7240

Fax

(786) 235-7241

NPI assigned

Aug 31, 2010

Organization subpart

No

Name

Mr. Igor Niznik

Title

President

Phone

(786) 235-7240

Tax ID family

125TH Street NM Corp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• 125St NM Corp

  • Specialist
  • North Miami, FL
  • NPI 1396033080
  NPD tax ID
• 125TH Street NM Corp

  • Multi-Specialty Clinic/Center
  • North Miami, FL
  • NPI 1255633046
  NPD tax ID
• 125TH Street NM Corp

  • Addiction Psychiatry Physician
  • North Miami, FL
  • NPI 1619352283
  NPD tax ID

Locations

• 125th Street Pain Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 31, 2010.

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1578879375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331614718",
            "telephone_number": "786-235-7240",
            "fax_number": "786-235-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331614718",
            "telephone_number": "786-235-7240",
            "fax_number": "786-235-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "125TH STREET NM CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "NIZNIK",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-235-7240",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PMC 20",
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "FL",
            "license": "PMC 20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "125th Street Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 125St NM Corp
• 125TH Street NM Corp
• 125TH Street NM Corp
• 305 Psychotherapy Group LLC
• 5 Star Premium Home Care Inc
• 5A Therapy LLC
• A & B Diagnos-Techs, LLC

• All providers in North Miami, FL
• Pain Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.