CMS Irrv Complex Trust

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

ME0043253 Issued in FL

Legal business name

CMS IRRV COMPLEX TRUST

Doing business as

Sebring Medical Walk-in Clinic

Practice address

343 S Commerce Ave
Sebring, FL 33870-3607

Phone

(863) 382-2772

Fax

(863) 382-3172

NPI assigned

Aug 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Cirilo M Seralde Jr., M.D.

Title

Director/Physician

Phone

(863) 382-2772

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Sebring Medical Walk-in Clinic Doing business as

Locations

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1659563971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 S COMMERCE AVE",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338703607",
            "telephone_number": "863-382-2772",
            "fax_number": "863-382-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 S COMMERCE AVE",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338703607",
            "telephone_number": "863-382-2772",
            "fax_number": "863-382-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMS IRRV COMPLEX TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "SERALDE",
        "authorized_official_first_name": "CIRILO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/PHYSICIAN",
        "authorized_official_telephone_number": "863-382-2772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME0043253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP MEDIPASS NUMBER",
            "identifier": "259715200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR.VICTOR SERALDE-UPIN",
            "identifier": "D21429",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER CIRILO SERALDE FOR SEBRING CLINIC",
            "identifier": "41214Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN GROUP NUMBER",
            "identifier": "K2381",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR.CIRILO SERALDE,JR-UPIN",
            "identifier": "D54734",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI -GROUP",
            "identifier": "1659563971",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sebring Medical Walk-in Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Sebring, FL
• Providers in Sebring, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.