Southeast Physician Associates Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

SOUTHEAST PHYSICIAN ASSOCIATES INC

Practice address

10621 N Kendall Dr
Suite 211
Miami, FL 33176-8708

Phone

(305) 458-1475

Fax

(305) 424-2054

NPI assigned

May 22, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Rene F Gomez

Title

President

Phone

(305) 458-1475

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400716800000",
    "number": "1750793907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10621 N KENDALL DR",
            "address_2": "SUITE 211",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331768708",
            "telephone_number": "305-458-1475",
            "fax_number": "305-424-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10621 N KENDALL DR",
            "address_2": "SUITE 211",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331768708",
            "telephone_number": "305-458-1475",
            "fax_number": "305-424-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST PHYSICIAN ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2014-05-22",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "RENE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-458-1475",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southdade Wellness, Inc
• Southeast Diagnostic Consultants, LLC
• Southeast Medical Lab Inc
• Southeast Medical Supplies Center Inc
• Southeast Physician Associates 1, LLC.
• Southeast Urgent Care Group, Inc.
• Southeast Woundcare Experts LLC
• Southeastern Community Mental Health Center Inc
• Southeastern Dental Associates VI
• Southeastern Med-Service Specialists, Inc.

• Exclusive Provider Organization in Miami, FL
• Providers in Miami, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.