The Pena Medical Group Co

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THE PENA MEDICAL GROUP CO

Practice address

330 SW 27TH Ave
Ste 701
Miami, FL 33135-2961

Phone

(305) 642-7186

Fax

(305) 642-5114

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Heriberto Pena, M.D

Title

President

Phone

(305) 642-7186

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1619004454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SW 27TH AVE",
            "address_2": "STE 701",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352961",
            "telephone_number": "305-642-7186",
            "fax_number": "305-642-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SW 27TH AVE",
            "address_2": "STE 701",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352961",
            "telephone_number": "305-642-7186",
            "fax_number": "305-642-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PENA MEDICAL GROUP CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "HERIBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-642-7186",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.