Organization Active NPI

Miami Medical & Wellness Center LLC

  • Adult Medicine Physician
  • Miami, FL
National Provider Identifier
1720456676
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
ME58111 Issued in FL
Legal business name
MIAMI MEDICAL & WELLNESS CENTER LLC
Practice address
7500 SW 8TH St
Suite 103
Miami, FL 33144-4400
Phone
(305) 534-0076
Fax
(305) 735-6471
NPI assigned
Sep 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Mr. Rodolfo Dumenigo Jr., M.DNPI 1003865213
Title
President
Phone
(305) 534-0076

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X ME58111 FL Primary

Addresses

Primary practice location

7500 SW 8TH St
Suite 103
Miami, FL 33144-4400

Mailing address

1200 Alton Rd
Miami Beach, FL 33139-3810
Phone (305) 534-0076

Other identifiers 4

IdentifierTypeStateIssuer
11761QOtherFLMEDICARE PTAN DUMENIGO
ID353AOtherFLMEDICARE PTAN
E6931SOtherFLMEDICARE PTAN ALONSO
GK944YOtherFLMEDICARE PTAN DE LEON

National Provider Directory

National Provider Directory

Locations

7500 SW 8th St
Ste 103
Miami, FL 33144
Phone (305) 261-0042

Practitioners & affiliated clinicians

Practitioners 1

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": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1720456676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ALTON RD",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331393810",
            "telephone_number": "305-534-0076",
            "fax_number": "305-907-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 SW 8TH ST",
            "address_2": "SUITE 103",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331444400",
            "telephone_number": "305-534-0076",
            "fax_number": "305-735-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI MEDICAL & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "DUMENIGO",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-534-0076",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME58111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN DUMENIGO",
            "identifier": "11761Q",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ID353A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN ALONSO",
            "identifier": "E6931S",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN DE LEON",
            "identifier": "GK944Y",
            "state": "FL"
        }
    ],
    "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 Sep 10, 2015; 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.