Organization Active NPI

Faith Temple Medical Center, LLC

Doing business as Faith Temple Medical Center

  • Family Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1619622073
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAITH TEMPLE MEDICAL CENTER, LLC
Doing business as
Faith Temple Medical Center
Practice address
2499 Glades Rd Ste 113
Boca Raton, FL 33431-7201
Phone
(561) 305-5668
NPI assigned
Feb 15, 2022
Last updated
Dec 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Michel Salomon
Title
President
Phone
(561) 305-5668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

2499 Glades Rd Ste 113
Boca Raton, FL 33431-7201

Mailing address

2499 Glades Rd Ste 113
Boca Raton, FL 33431-7201
Phone (561) 305-5668

Other names 1

  • Faith Temple Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221214003095 FL Part B Supplier - Clinic/Group Practice 9335518257 Receives reassigned benefits from 2 practitioners
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1619622073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2499 GLADES RD STE 113",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317201",
            "telephone_number": "561-305-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2499 GLADES RD STE 113",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317201",
            "telephone_number": "561-305-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH TEMPLE MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "SALOMON",
        "authorized_official_first_name": "MICHEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-305-5668"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faith Temple Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Faith Temple Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.