Organization Active NPI

Cutler Ridge Medical Center LLC

  • Internal Medicine Physician
  • Cutler Bay, FL
National Provider Identifier
1659505881
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME39949 Issued in FL
Legal business name
CUTLER RIDGE MEDICAL CENTER LLC
Practice address
10700 Caribbean Blvd
Suite 315
Cutler Bay, FL 33189-1232
Phone
(305) 238-2961
Fax
(305) 238-2618
NPI assigned
May 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Authorized official

Name
Mr. Wayne M Williams, M.D.
Title
MGMR
Phone
(305) 238-2961

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME39949 FL Primary

Addresses

Primary practice location

10700 Caribbean Blvd
Suite 315
Cutler Bay, FL 33189-1232

Mailing address

10700 Caribbean Blvd
Suite 315
Cutler Bay, FL 33189-1232
Phone (305) 238-2961

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250327003673 FL Part B Supplier - Clinic/Group Practice 3971769084 Receives reassigned benefits from 2 practitioners
Practice locations: Cutler Bay, FL

National Provider Directory

National Provider Directory

Locations

10700 Caribbean Blvd
Ste 315
Cutler Bay, FL 33189
Phone (305) 238-2961

Practitioners & affiliated clinicians

Practitioners 2

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": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1659505881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 CARIBBEAN BLVD",
            "address_2": "SUITE 315",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331891232",
            "telephone_number": "305-238-2961",
            "fax_number": "305-238-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 CARIBBEAN BLVD",
            "address_2": "SUITE 315",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331891232",
            "telephone_number": "305-238-2961",
            "fax_number": "305-238-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUTLER RIDGE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MGMR",
        "authorized_official_telephone_number": "305-238-2961",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME39949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.