NPIMap

Organization Active NPI

Med Plan Clinic LLC

  • Primary Care Clinic/Center
  • Pembroke Pines, FL
National Provider Identifier
1750735338
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MED PLAN CLINIC LLC
Practice address
9959 Pines Blvd
Pembroke Pines, FL 33024-6177
Phone
(954) 433-2524
NPI assigned
Apr 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Authorized official

Name
Mr. Manuel Igleasias
Title
Ceo
Phone
(786) 641-5348

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

9959 Pines Blvd
Pembroke Pines, FL 33024-6177

Mailing address

3155 NW 77TH Ave
Miami, FL 33122-1205
Phone (305) 790-8129

Other identifiers 1

IdentifierTypeStateIssuer
O18781000MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Medplan Clinic LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3155 NW 77th Ave
Miami, FL 33122

9959 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 433-2524

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497225600000",
    "number": "1750735338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 NW 77TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331221205",
            "telephone_number": "305-790-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9959 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246177",
            "telephone_number": "954-433-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED PLAN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2017-06-12",
        "status": "A",
        "authorized_official_last_name": "IGLEASIAS",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-641-5348",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "O18781000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.