Organization Active NPI

Shalom Medical Group LLC

  • Case Management Agency
  • Hialeah Gardens, FL
National Provider Identifier
1619793452
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SHALOM MEDICAL GROUP LLC
Practice address
8302 NW 103Rd St Ste 205
Hialeah Gardens, FL 33016-4698
Phone
(786) 651-2442
NPI assigned
Nov 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Surisaday Rones
Title
Owner
Phone
(786) 374-9928

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

8302 NW 103Rd St Ste 205
Hialeah Gardens, FL 33016-4698

Mailing address

8302 NW 103Rd St Ste 205
Hialeah Gardens, FL 33016-4698
Phone (786) 651-2442

National Provider Directory

National Provider Directory
Tax ID family
Shalom Medical Group 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.

Locations

8302 NW 103rd St
Ste 205
Hialeah Gardens, FL 33016
Phone (786) 651-2442

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1619793452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8302 NW 103RD ST STE 205",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330164698",
            "telephone_number": "786-651-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8302 NW 103RD ST STE 205",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330164698",
            "telephone_number": "786-651-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "RONES",
        "authorized_official_first_name": "SURISADAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-374-9928"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.