Organization Active NPI

Mci Clinical Research and Wellness Center LLC

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1659023927
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MCI CLINICAL RESEARCH AND WELLNESS CENTER LLC
Practice address
11410 SW 88TH St Ste 203
Miami, FL 33176-1031
Phone
(786) 679-1425
NPI assigned
Jan 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Mr. Crisitian German Macagni
Title
Owner
Phone
(786) 682-3232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

11410 SW 88TH St Ste 203
Miami, FL 33176-1031

Mailing address

11410 SW 88TH St Ste 203
Miami, FL 33176-1031

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220808002403 FL Part B Supplier - Clinic/Group Practice 1456733435 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

11410 SW 88th St
Ste 203
Miami, FL 33176
Phone (786) 679-1425

11410 N Kendall Dr
Ste 2
Miami, FL 33176

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1659023927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11410 SW 88TH ST STE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 SW 88TH ST STE 203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761031",
            "telephone_number": "786-679-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCI CLINICAL RESEARCH AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "MACAGNI",
        "authorized_official_first_name": "CRISITIAN",
        "authorized_official_middle_name": "GERMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-682-3232",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.