Red Diamond Medical Group LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

ME104754 Issued in FL

Legal business name

RED DIAMOND MEDICAL GROUP LLC

Practice address

85 Grand Canal Dr Ste 107
Miami, FL 33144-2566

Phone

(305) 261-0057

Fax

(305) 261-0058

NPI assigned

Oct 18, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Alberto Burgos-Tiburcio, M.D.

Title

Owner/President

Phone

(305) 261-0057

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1629529359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 GRAND CANAL DR SUITE 107",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33144",
            "telephone_number": "305-261-0057",
            "fax_number": "305-261-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 GRAND CANAL DR STE 107",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331442566",
            "telephone_number": "305-261-0057",
            "fax_number": "305-261-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED DIAMOND MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "BURGOS-TIBURCIO",
        "authorized_official_first_name": "ALBERTO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "305-261-0057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "ME104754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001381800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.