Florida Memorial University

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

FLORIDA MEMORIAL UNIVERSITY

Doing business as

Florida Memorial Sports Medicine

Practice address

15800 NW 42ND Ave
Miami Gardens, FL 33054-6155

Phone

(972) 367-4845

NPI assigned

Mar 30, 2018

Organization subpart

No

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

Authorized official

Name

Mouzon Bass III

Title

Administrator

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• Florida Memorial Sports Medicine Doing business as

Locations

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1619472644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 NW 42ND AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330546155",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MEMORIAL UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Memorial Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yilian Maria Fleites Rojas
• Yanelys Fleites
• Ryan Fleming, MSW
• Liliet Flores Pons
• Florida Home Care Alf II Inc
• Florida Pediatric Care Centers 1 LLC
• Florida Pharmacy No 2 Inc (florida pharmacy # 2)
• Florida USA Supplies Inc
• Lian Florido Garcia
• Lianet Florido Garcia

• Orthopaedic Surgery Physician in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.