NPIMap

Organization Active NPI

South Psychological & Physical Rehabilitation, Inc

  • Family Medicine Physician
  • Homestead, FL
National Provider Identifier
1760819635
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTH PSYCHOLOGICAL & PHYSICAL REHABILITATION, INC
Practice address
1408 NE 1St Ave
Homestead, FL 33030-4535
Phone
(305) 242-1399
Fax
(305) 242-9442
NPI assigned
Oct 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Kadel Torres
Title
President
Phone
(305) 242-1399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1408 NE 1St Ave
Homestead, FL 33030-4535

Mailing address

1408 NE 1St Ave
Homestead, FL 33030-4535
Phone (305) 242-1399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131010001513 FL Part B Supplier - Clinic/Group Practice 0143345595 Receives reassigned benefits from 2 practitioners
Practice locations: Homestead, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
South Psychological Physical Rehabilitation Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1408 NE 1st Ave
Homestead, FL 33030
Phone (305) 242-1399

Practitioners & affiliated clinicians

Practitioners 5

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": "1381190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1760819635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 NE 1ST AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304535",
            "telephone_number": "305-242-1399",
            "fax_number": "305-242-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 NE 1ST AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304535",
            "telephone_number": "305-242-1399",
            "fax_number": "305-242-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PSYCHOLOGICAL & PHYSICAL REHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-08",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "KADEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-242-1399"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.