NPIMap

Organization Active NPI

St Jude Medical Clinic Inc

  • General Practice Physician
  • Coral Gables, FL
National Provider Identifier
1700207479
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
HCC10040 Issued in FL
Legal business name
ST JUDE MEDICAL CLINIC INC
Practice address
5200 SW 8TH St
Suite 200
Coral Gables, FL 33134-2300
Phone
(305) 569-0349
NPI assigned
Dec 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Authorized official

Name
Juan Riveron
Title
Owner
Phone
(305) 569-0349

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X HCC10040 FL Primary

Addresses

Primary practice location

5200 SW 8TH St
Suite 200
Coral Gables, FL 33134-2300

Mailing address

5200 SW 8TH St
Suite 200
Coral Gables, FL 33134-2300
Phone (305) 569-0349

Other identifiers 1

IdentifierTypeStateIssuer
HCC10040OtherFLHEALTH CARE CLINIC

National Provider Directory

National Provider Directory
Tax ID family
St Jude Medical Clinic Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1700207479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SW 8TH ST",
            "address_2": "SUITE 200",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342300",
            "telephone_number": "305-569-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 SW 8TH ST",
            "address_2": "SUITE 200",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342300",
            "telephone_number": "305-569-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JUDE MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "RIVERON",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-569-0349"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "HCC10040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH CARE CLINIC",
            "identifier": "HCC10040",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.