NPIMap

Organization Active NPI

Complete Care Management Services Aco LLC

  • Primary Care Clinic/Center
  • Miami Lakes, FL
National Provider Identifier
1780197152
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COMPLETE CARE MANAGEMENT SERVICES ACO LLC
Practice address
6625 Miami Lakes Dr Ste 247
Miami Lakes, FL 33014-2768
Phone
(786) 292-4797
Fax
(866) 317-9048
NPI assigned
Nov 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Authorized official

Name
Mr. Mario Armando Espino Jr.
Title
Founder-Cob
Phone
(786) 395-1165

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Multi-Specialty Clinic/Center 261QM1300X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

6625 Miami Lakes Dr Ste 247
Miami Lakes, FL 33014-2768

Mailing address

6625 Miami Lakes Dr Ste 247
Miami Lakes, FL 33014-2768
Phone (786) 292-4797

Other practice location 1

331 W Central Ave Ste 243
Winter Haven, FL 33880-2983
Phone (877) 212-2267

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191111000864 FL Part B Supplier - Clinic/Group Practice 7012349285 Receives reassigned benefits from 12 practitioners
Practice locations: Coral Gables, FL; Lakeland, FL; Miramar, FL

National Provider Directory

National Provider Directory

Locations

625 Commerce Dr
Ste 105
Lakeland, FL 33813
Phone (877) 212-2267

6625 Miami Lakes Dr
Ste 364
Miami Lakes, FL 33014
Phone (786) 292-4797

6625 Miami Lakes Dr E
Ste 247
Miami Lakes, FL 33014
Phone (786) 292-4797

3400 Lakeside Dr
Ste 525
Miramar, FL 33027
Phone (877) 212-2267

18260 NE 19th Ave
Ste 202
North Miami Beach, FL 33162
Phone (786) 292-4797

331 W Central Ave
Ste 243
Winter Haven, FL 33880
Phone (877) 212-2267

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FGBIBD

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1780197152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 MIAMI LAKES DR STE 247",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142768",
            "telephone_number": "786-292-4797",
            "fax_number": "866-317-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 MIAMI LAKES DR STE 247",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142768",
            "telephone_number": "786-292-4797",
            "fax_number": "866-317-9048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 W Central Ave Ste 243",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338802983",
            "country_code": "US",
            "telephone_number": "877-212-2267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMPLETE CARE MANAGEMENT SERVICES ACO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "ESPINO",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "ARMANDO",
        "authorized_official_title_or_position": "FOUNDER-COB",
        "authorized_official_telephone_number": "786-395-1165",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.