Legacy Medical Center LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

LEGACY MEDICAL CENTER LLC

Practice address

6741 SW 24TH St Ste 46
Miami, FL 33155-1767

Phone

(786) 427-7059

NPI assigned

Apr 2, 2021

Organization subpart

No

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

Authorized official

Name

Alfredo Cuba

Title

Ceo

Phone

(786) 263-3100

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1700465226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6741 SW 24TH ST STE 46",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551767",
            "telephone_number": "786-427-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6741 SW 24TH ST STE 46",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551767",
            "telephone_number": "786-427-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-02",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "CUBA",
        "authorized_official_first_name": "ALFREDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-263-3100"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101681100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Miami, FL
• Providers in Miami, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.