NPIMap

Organization Active NPI

Palm Plaza Medical Center, LLC

  • Clinic/Center
  • Hialeah, FL
National Provider Identifier
1699015701
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PALM PLAZA MEDICAL CENTER, LLC
Practice address
16795 NW 67TH Ave
Hialeah, FL 33015-4201
Phone
(305) 913-7300
Fax
(305) 362-9776
NPI assigned
Feb 26, 2013
Last updated
Feb 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Authorized official

Name
Mr. Paul Pino
Title
Ceo
Phone
(305) 913-9444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

16795 NW 67TH Ave
Hialeah, FL 33015-4201

Mailing address

2600 Douglas Rd
PH 7
Coral Gables, FL 33134
Phone (305) 913-9444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160818001144 FL Part B Supplier - Clinic/Group Practice 8224323050 Receives reassigned benefits from 72 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Land O Lakes, FL; Plantation, FL; Port Richey, FL; Sebring, FL; Plant City, FL; Spring Hill, FL; Tamarac, FL; Tampa, FL…

Other NPIs on the same Medicare enrollment 7

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

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
10D2102905Palm Plaza Medical Center LLC16795 NW 67TH Ave, Miami, FL 33015Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 7

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": "1361836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1699015701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 DOUGLAS RD",
            "address_2": "PH 7",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "305-913-9444",
            "fax_number": "305-913-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16795 NW 67TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330154201",
            "telephone_number": "305-913-7300",
            "fax_number": "305-362-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM PLAZA MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "PINO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-913-9444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.