Organization Active NPI

Vitacare Medical Group, LLC.

  • Primary Care Clinic/Center
  • Miami, FL
National Provider Identifier
1700730462
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
VITACARE MEDICAL GROUP, LLC.
Practice address
10453 SW 40TH St
Miami, FL 33165-3753
Phone
(786) 684-6845
NPI assigned
Feb 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Authorized official

Name
Imayacil Marzo Hernandez, RN, MSNNPI 1326953795
Title
Administrator
Phone
(786) 684-6845

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

10453 SW 40TH St
Miami, FL 33165-3753

Mailing address

10453 SW 40TH St
Miami, FL 33165-3753
Phone (786) 580-5182

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
10D2343178Vitacare Medical Group, LLC10453 SW 40TH St, Miami, FL 33165Certificate of waiverMay 1, 2028

National Provider Directory

National Provider Directory

Locations

10453 SW 40th St
Miami, FL 33165
Phone (786) 580-5182

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1771545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1700730462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10453 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653753",
            "telephone_number": "786-580-5182",
            "fax_number": "806-278-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10453 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653753",
            "telephone_number": "786-684-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITACARE MEDICAL GROUP, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-20",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "MARZO HERNANDEZ",
        "authorized_official_first_name": "IMAYACIL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "786-684-6845",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.