NPIMap

Organization Active NPI

Arelis M. Madera, MD, PA

  • Medical Specialty Clinic/Center
  • Port Charlotte, FL
National Provider Identifier
1659517076
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
ME74893 Issued in FL
Legal business name
ARELIS M. MADERA, MD, PA
Practice address
3611 Tamiami TRL
Suite B
Port Charlotte, FL 33952-5528
Phone
(941) 235-0542
Fax
(941) 235-0545
NPI assigned
Jan 7, 2009
Last updated
Jan 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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

Authorized official

Name
Dr. Arelis M Madera, MDNPI 1487697272
Title
President
Phone
(941) 235-0542

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X ME74893 FL Primary

Addresses

Primary practice location

3611 Tamiami TRL
Suite B
Port Charlotte, FL 33952-5528

Mailing address

3611 Tamiami TRL
Suite B
Port Charlotte, FL 33952-5528
Phone (941) 235-0542

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231286400000",
    "number": "1659517076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 TAMIAMI TRL",
            "address_2": "SUITE B",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525528",
            "telephone_number": "941-235-0542",
            "fax_number": "941-235-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 TAMIAMI TRL",
            "address_2": "SUITE B",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525528",
            "telephone_number": "941-235-0542",
            "fax_number": "941-235-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARELIS M. MADERA, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A",
        "authorized_official_last_name": "MADERA",
        "authorized_official_first_name": "ARELIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-235-0542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME74893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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.