Organization Active NPI

South Florida Doctors Group, PLLC

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1689115081
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SOUTH FLORIDA DOCTORS GROUP, PLLC
Practice address
18503 Pines Blvd Ste 306
Pembroke Pines, FL 33029-1406
Phone
(954) 442-0784
Fax
(855) 840-7185
NPI assigned
Mar 17, 2017
Last updated
Jun 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Authorized official

Name
Aurelio Torres Consuegra, MDNPI 1376720458
Title
MD/Owner
Phone
(954) 442-0784

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

18503 Pines Blvd Ste 306
Pembroke Pines, FL 33029-1406

Mailing address

18503 Pines Blvd Ste 306
Pembroke Pines, FL 33029-1406
Phone (954) 442-0784

Other practice location 1

3412 W 84th St Ste 104
Hialeah, FL 33018-4918
Phone (305) 512-9002

Other practice location 2

1779 N University Dr Ste 102
Pembroke Pines, FL 33024-0929
Phone (954) 885-6565

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180417001002 FL Part B Supplier - Clinic/Group Practice 2062775406 Receives reassigned benefits from 4 practitioners
Practice locations: Davie, FL; Hialeah, FL; Pembroke Pines, FL

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
10D2147662South Florida Doctors Group, PLLC18503 Pines Blvd Ste 306, Pembroke Pines, FL 33029Certificate of waiverApr 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
South Florida Doctors Group PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

3412 W 84th St
#104
Hialeah, FL 33018

3412 W 84th St
Ste 102104
Hialeah, FL 33018

1779 N University Dr
Ste 104
Hollywood, FL 33024

Practitioners & affiliated clinicians

Practitioners 5

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": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1689115081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD STE 306",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291406",
            "telephone_number": "954-442-0784",
            "fax_number": "855-840-7185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18503 PINES BLVD STE 306",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291406",
            "telephone_number": "954-442-0784",
            "fax_number": "855-840-7185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3412 W 84th St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330184918",
            "country_code": "US",
            "telephone_number": "305-512-9002",
            "fax_number": "855-840-7185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1779 N University Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330240929",
            "country_code": "US",
            "telephone_number": "954-885-6565",
            "fax_number": "888-727-7735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH FLORIDA DOCTORS GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "TORRES CONSUEGRA",
        "authorized_official_first_name": "AURELIO",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "954-442-0784",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.