NPIMap

Organization Active NPI

Kendall Medical Center, Inc

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1811951247
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS0001730 Issued in FL
Legal business name
KENDALL MEDICAL CENTER, INC
Practice address
11120 N Kendall Dr
Suite 100
Miami, FL 33176-1473
Phone
(305) 279-0808
Fax
(305) 271-4916
NPI assigned
Apr 13, 2006
Reactivated
Jun 24, 2009
Last updated
Jun 24, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
KENDALL MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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

Authorized official

Name
Mrs. Maribel Schwaninger
Title
Office Manager
Phone
(305) 279-0808

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS 8030 FL
Family Medicine Physician 207Q00000X OS0001730 FL Primary

Addresses

Primary practice location

11120 N Kendall Dr
Suite 100
Miami, FL 33176-1473

Mailing address

11120 N Kendall Dr
Suite 100
Miami, FL 33176-1473
Phone (305) 279-0808

Other identifiers 2

IdentifierTypeStateIssuer
254263300MedicaidFL
261046900MedicaidFL

National Provider Directory

National Provider Directory
Part of
Kendall Medical Center Inc

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245801600000",
    "number": "1811951247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 N KENDALL DR",
            "address_2": "SUITE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761473",
            "telephone_number": "305-279-0808",
            "fax_number": "305-271-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 N KENDALL DR",
            "address_2": "SUITE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761473",
            "telephone_number": "305-279-0808",
            "fax_number": "305-271-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALL MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENDALL MEDICAL CENTER, INC.",
        "enumeration_date": "2006-04-13",
        "last_updated": "2009-06-24",
        "deactivation_date": "2009-05-07",
        "reactivation_date": "2009-06-24",
        "status": "A",
        "authorized_official_last_name": "SCHWANINGER",
        "authorized_official_first_name": "MARIBEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-279-0808",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 8030",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0001730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254263300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261046900",
            "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 Jun 24, 2009; 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.