NPIMap

Organization Active NPI

Independent Medical Group, LLC.

  • Infectious Disease Physician
  • Coconut Creek, FL
National Provider Identifier
1689327074
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
INDEPENDENT MEDICAL GROUP, LLC.
Practice address
3880 Coconut Creek Pkwy Ste 100
Coconut Creek, FL 33066-1643
Phone
(407) 312-7392
NPI assigned
Jan 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Sonia N Torres
Title
Clinical Operations Manager
Phone
(407) 505-6435

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0200X Primary
Health Service Clinic/Center 261QH0100X

Addresses

Primary practice location

3880 Coconut Creek Pkwy Ste 100
Coconut Creek, FL 33066-1643

Mailing address

5701 NW 88TH Ave Ste 390
Tamarac, FL 33321-4451
Phone (407) 860-0283

Other identifiers 1

IdentifierTypeStateIssuer
850496596OtherFLHRSA

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL www.imghealthclinic.com Other
Other URL www.imghealthclinic.com Other

National Provider Directory

National Provider Directory
Tax ID family
Independent Medical Group LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1689327074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 NW 88TH AVE STE 390",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333214451",
            "telephone_number": "407-860-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 COCONUT CREEK PKWY STE 100",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661643",
            "telephone_number": "407-312-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT MEDICAL GROUP, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-27",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "SONIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CLINICAL OPERATIONS MANAGER",
        "authorized_official_telephone_number": "407-505-6435"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HRSA",
            "identifier": "850496596",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.imghealthclinic.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "www.imghealthclinic.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "www.imghealthclinic.com",
            "address_1": "3880 Coconut Creek Pkwy Ste 100",
            "city": "Coconut Creek",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330661643",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.imghealthclinic.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "www.imghealthclinic.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "www.imghealthclinic.com",
            "address_1": "3880 Coconut Creek Pkwy Ste 100",
            "city": "Coconut Creek",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330661643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.