NPIMap

Organization Active NPI

Kidz Medical Services, Inc

  • Pediatric Gastroenterology Physician
  • Miramar, FL
National Provider Identifier
1689114480
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME58352 Issued in FL
Legal business name
KIDZ MEDICAL SERVICES, INC
Practice address
3000 SW 148TH Ave
Suite 112
Miramar, FL 33027-4181
Phone
(954) 967-9400
Fax
(954) 967-9551
NPI assigned
Feb 28, 2017
Last updated
Feb 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Authorized official

Name
Jorge E Perez, MD
Title
Medical Director
Phone
(305) 661-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME58352 FL Primary

Addresses

Primary practice location

3000 SW 148TH Ave
Suite 112
Miramar, FL 33027-4181

Mailing address

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone (305) 661-1515

Other identifiers 1

IdentifierTypeStateIssuer
257829800MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041105000218 FL Part B Supplier - Clinic/Group Practice 3678536240 Receives reassigned benefits from 82 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, FL; Miramar, FL; Naples, FL; Palm Beach Gardens, FL; South Miami, FL; West Palm Beach, FL; Belle Glade, FL; Homestead, FL…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Kidz Medical Services16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

3000 SW 148th Ave
Ste 112
Miramar, FL 33027
Phone (954) 967-9400

Practitioners & affiliated clinicians

Practitioners 2

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": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1689114480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515",
            "fax_number": "305-663-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SW 148TH AVE",
            "address_2": "SUITE 112",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274181",
            "telephone_number": "954-967-9400",
            "fax_number": "954-967-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ MEDICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "305-661-1515",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME58352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257829800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

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