NPIMap

Organization Active NPI

Centers of Medical Excellence, LLC

  • General Practice Physician
  • Miami Lakes, FL
National Provider Identifier
1679304570
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CENTERS OF MEDICAL EXCELLENCE, LLC
Practice address
15529 Bull Run Rd.
Miami Lakes, FL 33014-7004
Phone
(305) 328-8922
Fax
(786) 224-6489
NPI assigned
Aug 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Sadita Bustamante
Title
Coo
Phone
(305) 874-3909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

15529 Bull Run Rd.
Miami Lakes, FL 33014-7004

Mailing address

7925 NW 12 Street
Suite 201
Doral, FL 33126-1821
Phone (305) 874-3909

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2185736Centers of Medical Excellence, LLC15529 Bull Run Rd, Miami Lakes, FL 33014Certificate of waiverJun 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
Centers of Medical Excellence LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7925 NW 12th St
Ste 201
Doral, FL 33126

Networks

  • HealthSun Health Plans Network

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1679304570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 NW 12 STREET",
            "address_2": "SUITE 201",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261821",
            "telephone_number": "305-874-3909",
            "fax_number": "305-874-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15529 BULL RUN RD.",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330147004",
            "telephone_number": "305-328-8922",
            "fax_number": "786-224-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERS OF MEDICAL EXCELLENCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "BUSTAMANTE",
        "authorized_official_first_name": "SADITA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "305-874-3909"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.