Organization Active NPI

Preventive and Primary Care Medical Center Inc

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1669742003
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PREVENTIVE AND PRIMARY CARE MEDICAL CENTER INC
Practice address
10250 SW 56TH St
Suite C101
Miami, FL 33165-7069
Phone
(786) 558-8901
Fax
(786) 558-8917
NPI assigned
Jan 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Mrs. Magalis Villalba
Title
Co-Owner
Phone
(786) 558-8901

Specialties & licenses 1

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

Addresses

Primary practice location

10250 SW 56TH St
Suite C101
Miami, FL 33165-7069

Mailing address

10250 SW 56TH St
Suite C101
Miami, FL 33165-7069
Phone (786) 558-8901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130809000417 FL Part B Supplier - Clinic/Group Practice 1052553609 Receives reassigned benefits from 4 practitioners
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

10250 SW 56th St
Ste C101
Miami, FL 33165
Phone (786) 558-8901

Practitioners & affiliated clinicians

Practitioners 4

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": "1325462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1669742003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 SW 56TH ST",
            "address_2": "SUITE C101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657069",
            "telephone_number": "786-558-8901",
            "fax_number": "786-558-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 SW 56TH ST",
            "address_2": "SUITE C101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657069",
            "telephone_number": "786-558-8901",
            "fax_number": "786-558-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE AND PRIMARY CARE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-02",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "VILLALBA",
        "authorized_official_first_name": "MAGALIS",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "786-558-8901",
        "authorized_official_name_prefix": "Mrs."
    },
    "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 Oct 6, 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.