NPIMap

Organization Active NPI

MGM Ipa Dade 001 LLC

  • Internal Medicine Physician
  • Cutler Bay, FL
National Provider Identifier
1619303112
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MGM IPA DADE 001 LLC
Practice address
8318 SW 193Rd St
Cutler Bay, FL 33157-8085
Phone
(305) 964-5119
NPI assigned
Sep 17, 2013
Last updated
Sep 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Authorized official

Name
Mr. Mario Armando Espino Jr.
Title
Ceo/President
Phone
(786) 395-1165

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Exclusive Provider Organization 302F00000X

Addresses

Primary practice location

8318 SW 193Rd St
Cutler Bay, FL 33157-8085

Mailing address

8318 SW 193Rd St
Cutler Bay, FL 33157-8085
Phone (305) 964-5119

National Provider Directory

National Provider Directory
Tax ID family
MGM Ipa Dade 001 LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1619303112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8318 SW 193RD ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331578085",
            "telephone_number": "305-964-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8318 SW 193RD ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331578085",
            "telephone_number": "305-964-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGM IPA DADE 001 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "ESPINO",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "ARMANDO",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "786-395-1165",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.