NPIMap

Organization Active NPI

St. John Clinic Medical Center

  • Multi-Specialty Clinic/Center
  • Miami, FL
National Provider Identifier
1760470652
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ST. JOHN CLINIC MEDICAL CENTER
Practice address
161 NW 29TH St
Miami, FL 33127-3929
Phone
(305) 576-0231
Fax
(305) 573-1458
NPI assigned
Oct 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Reynaldo Cruz
Title
Ceo
Phone
(305) 576-0231

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X FL
Multi-Specialty Clinic/Center 261QM1300X FL Primary
Primary Care Clinic/Center 261QP2300X FL

Addresses

Primary practice location

161 NW 29TH St
Miami, FL 33127-3929

Mailing address

161 NW 29TH St
Miami, FL 33127-3929
Phone (305) 576-0231

Other identifiers 2

IdentifierTypeStateIssuer
4624OtherFLTOTAL HEALTH CHOICE
060387200MedicaidFL

National Provider Directory

National Provider Directory

Locations

156 NW 29th St
Miami, FL 33127
Phone (305) 576-0231

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1760470652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 NW 29TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331273929",
            "telephone_number": "305-576-0231",
            "fax_number": "305-573-1458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 NW 29TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331273929",
            "telephone_number": "305-576-0231",
            "fax_number": "305-573-1458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN CLINIC MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "REYNALDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-576-0231",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOTAL HEALTH CHOICE",
            "identifier": "4624",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060387200",
            "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 Jul 21, 2022; 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.