NPIMap

Organization Active NPI

Miracle Community Behavioral Center Corp

Doing business as Miracle Medical Center

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1700491552
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MIRACLE COMMUNITY BEHAVIORAL CENTER CORP
Doing business as
Miracle Medical Center
Practice address
15660 SW 72ND St
Miami, FL 33193-1923
Phone
(786) 697-1150
NPI assigned
Sep 9, 2020
Last updated
Aug 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Authorized official

Name
Brisaida Duarte
Title
Ceo
Phone
(786) 697-1150

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary
Physical Therapist 225100000X
Physical Therapy Assistant 225200000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

15660 SW 72ND St
Miami, FL 33193-1923

Mailing address

15660 SW 72ND St
Miami, FL 33193-1923
Phone (786) 697-1150

Other practice location 1

10549 N Florida Ave Ste F
Tampa, FL 33612-6707
Phone (786) 697-1150

Other identifiers 3

IdentifierTypeStateIssuer
118354400MedicaidFL
15527884OtherFLCAQH
42711OtherFLHEALTH CARE CLINIC CERTIFICATE (AHCA)

Other names 1

  • MIRACLE MEDICAL CENTER Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://static.practicefusion.com/apps/ehr/index.html#/ Health Information Exchange (HIE)
Other URL https://static.practicefusion.com/apps/ehr/index.html#/ Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

15660 SW 72nd St
Miami, FL 33193
Phone (786) 498-6502

Practitioners & affiliated clinicians

Practitioners 2

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": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1700491552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15660 SW 72ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331931923",
            "telephone_number": "786-697-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15660 SW 72ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331931923",
            "telephone_number": "786-697-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10549 N Florida Ave Ste F",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336126707",
            "country_code": "US",
            "telephone_number": "786-697-1150",
            "fax_number": "786-541-1526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIRACLE COMMUNITY BEHAVIORAL CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "DUARTE",
        "authorized_official_first_name": "BRISAIDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-697-1150"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118354400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15527884",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH CARE CLINIC  CERTIFICATE (AHCA)",
            "identifier": "42711",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://static.practicefusion.com/apps/ehr/index.html#/",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15660 SW 72nd St",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331931923",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://static.practicefusion.com/apps/ehr/index.html#/",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10549 N Florida Ave Ste F",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336126707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MIRACLE MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.