Organization Active NPI

Magi Health Care Clinic Inc

  • Primary Care Clinic/Center
  • Miami Lakes, FL
National Provider Identifier
1609184407
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
HCC8678 Issued in FL
Legal business name
MAGI HEALTH CARE CLINIC INC
Practice address
5803 NW 151St St Ste 301
Miami Lakes, FL 33014-2478
Phone
(786) 422-7374
Fax
(786) 422-7375
NPI assigned
Sep 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Authorized official

Name
Tamara Rodriguez
Title
President
Phone
(786) 422-7374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X HCC8678 FL Primary

Addresses

Primary practice location

5803 NW 151St St Ste 301
Miami Lakes, FL 33014-2478

Mailing address

5803 NW 151St St Ste 301
Miami Lakes, FL 33014-2478
Phone (786) 422-7374

Other identifiers 1

IdentifierTypeStateIssuer
1609184407MedicaidFL

Other names 1

  • Abuelitos Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110419000745 FL Part B Supplier - Clinic/Group Practice 7517142441 Receives reassigned benefits from 2 practitioners
Practice locations: Hialeah, FL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2004027Magi Health Care Clinic Inc5803 NW 151St Suite #'S 301-303-305-307, Miami Lakes, FL 33014Certificate of waiverFeb 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Magi Health Care Clinic Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

600 E 25th St
Ste Abc
Hialeah, FL 33013
Phone (786) 422-7374

5803 NW 151st St
Ste 301
Miami Lakes, FL 33014
Phone (786) 422-7374

Ownership & related parties

Subparts reporting this organization as parent 1

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1284508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1609184407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 NW 151ST ST STE 301",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142478",
            "telephone_number": "786-422-7374",
            "fax_number": "786-422-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 NW 151ST ST STE 301",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142478",
            "telephone_number": "786-422-7374",
            "fax_number": "786-422-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGI HEALTH CARE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-15",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-422-7374"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "HCC8678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609184407",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abuelitos Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Abuelitos Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.