M&V San Jose Medical Center LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

M&V SAN JOSE MEDICAL CENTER LLC

Practice address

12750 SW 128TH St Ste 108
Miami, FL 33186-5380

Phone

(786) 713-0970

Fax

(786) 592-2008

NPI assigned

Jul 19, 2019

Last updated

May 9, 2023By 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

Mabel Marichal, PANPI 1366813966

Title

MGR

Phone

(786) 409-9490

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mabel Marichal, PA

  • Medical Physician Assistant
  • Miami, FL
  • NPI 1366813966
  Medicare reassignment Authorized official
• Derek Glenn Bazemore Jr., MD

  • Family Medicine Physician
  • Miami, FL
  • NPI 1639495245
  Medicare reassignment NPD
• Robert Morales, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
  • NPI 1184212276
  Medicare reassignment NPD
• Julie Eugenia Velazquez, MSN, FNP-C, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
  • NPI 1922697911
  NPD

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1598318495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12750 SW 128TH ST STE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865380",
            "telephone_number": "786-409-9490",
            "fax_number": "786-592-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 SW 128TH ST STE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865380",
            "telephone_number": "786-713-0970",
            "fax_number": "786-592-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M&V SAN JOSE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-19",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "MARICHAL",
        "authorized_official_first_name": "MABEL",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "786-409-9490",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M&M Medical Center Inc.
• M&M Medical Supplies Inc.
• M&M Rehabilitation Center, Inc
• M&M Rehabilitation Center, Inc
• M&V Caring Therapy Corp
• Ma Emergency Associates PL
• Ma Home Health LLC
• Ma Massage Services Corp
• Ma-Ga Family LLC
• Ma-R Medical Center Inc

• Family Medicine Physician in Miami, FL
• Providers in Miami, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.