Prada Medical Center Group Corp.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

HCC7148 Issued in FL

Legal business name

PRADA MEDICAL CENTER GROUP CORP.

Practice address

3900 NW 79TH Ave
Suite 728
Doral, FL 33166-6556

Phone

(786) 439-5919

Fax

(305) 675-2668

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Nedel J Barata

Title

President/Owner

Phone

(786) 439-5919

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790878742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE",
            "address_2": "SUITE 728",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666556",
            "telephone_number": "786-439-5919",
            "fax_number": "305-675-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE",
            "address_2": "SUITE 728",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666556",
            "telephone_number": "786-439-5919",
            "fax_number": "305-675-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRADA MEDICAL CENTER GROUP CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARATA",
        "authorized_official_first_name": "NEDEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "786-439-5919",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "HCC7148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA LICENSE",
            "identifier": "HCC7148",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Doral, FL
• Providers in Doral, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.