Individual provider Active NPI

Indira Lamothe Denis

  • Primary Care Clinic/Center
  • Miramar, FL
National Provider Identifier
1609584895
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Practice address
4700 SW 153Rd Ter
Miramar, FL 33027-3660
Phone
(678) 964-0265
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

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

Addresses

Primary practice location

4700 SW 153Rd Ter
Miramar, FL 33027-3660

Mailing address

4700 SW 153Rd Ter
Miramar, FL 33027-3660
Phone (678) 964-0265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1609584895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 SW 153RD TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273660",
            "telephone_number": "678-964-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SW 153RD TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273660",
            "telephone_number": "678-964-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIS",
        "first_name": "INDIRA",
        "middle_name": "LAMOTHE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.