Meraki Medical Center LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MERAKI MEDICAL CENTER LLC

Practice address

12565 Orange Dr Ste 401
Davie, FL 33330-4305

Phone

(954) 998-7574

Fax

(954) 251-4846

NPI assigned

Sep 21, 2020

Organization subpart

No

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

Authorized official

Name

Lydia Arvelo

Title

Credentialing Specialist

Phone

(954) 998-7574

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1740896281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12565 ORANGE DR STE 401",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304305",
            "telephone_number": "954-998-7574",
            "fax_number": "954-251-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12565 ORANGE DR STE 401",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304305",
            "telephone_number": "954-998-7574",
            "fax_number": "954-251-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERAKI MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "ARVELO",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "954-998-7574"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Davie, FL
• Providers in Davie, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.