Anselmo Manuel Mendive, MD. PA.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME56412 Issued in FL

Legal business name

ANSELMO MANUEL MENDIVE, MD. PA.

Practice address

4601 NW 199TH St
Suite E
Miami Gardens, FL 33055-1508

Phone

(305) 801-7030

Fax

(305) 623-7044

NPI assigned

Feb 16, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Yin Garcia

Title

Office Manager

Phone

(305) 801-7030

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anselmo M Mendive, MD

  • Family Medicine Physician
  • Miami Gardens, FL
  • NPI 1427229384
  Medicare reassignment NPD

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327968000000",
    "number": "1619011228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 NW 199TH ST",
            "address_2": "SUITE E",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330551508",
            "telephone_number": "305-801-7030",
            "fax_number": "305-623-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 NW 199TH ST",
            "address_2": "SUITE E",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330551508",
            "telephone_number": "305-801-7030",
            "fax_number": "305-623-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANSELMO MANUEL MENDIVE, MD. PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2012-01-31",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "YIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-801-7030",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME56412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048992100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048992101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Miami Gardens, FL
• Providers in Miami Gardens, 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 Jan 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.