Center for Independent Living of South Florida, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

681792196 Issued in FL

Legal business name

CENTER FOR INDEPENDENT LIVING OF SOUTH FLORIDA, INC.

Practice address

4770 Biscayne Blvd. Suite 150
Miami, FL 33137

Phone

(305) 751-8025

Fax

(305) 751-8944

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Peter O'Connell

Title

Ceo

Phone

(305) 751-8025

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556064000000",
    "number": "1639236607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 BISCAYNE BLVD. SUITE 150",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33137",
            "telephone_number": "305-751-8025",
            "fax_number": "305-751-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 BISCAYNE BLVD. SUITE 150",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33137",
            "telephone_number": "305-751-8025",
            "fax_number": "305-751-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INDEPENDENT LIVING OF SOUTH FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2019-04-24",
        "status": "A",
        "authorized_official_last_name": "O'CONNELL",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-751-8025"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "681792196",
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "681792198",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "681792198",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "681792196",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.