North Miami Medical Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

HCC4445 Issued in FL

Legal business name

NORTH MIAMI MEDICAL INC

Practice address

823 NE 125TH St
North Miami, FL 33161-5711

Phone

(305) 895-7840

Fax

(305) 895-9557

NPI assigned

Jun 18, 2007

Last updated

Dec 19, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jean Paul Metellus

Title

Owner

Phone

(305) 895-7840

Specialties & licenses 1

Addresses

Other names 1

• NORTH MIAMI MEDICAL AND REHAB INC Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1821293127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615711",
            "telephone_number": "305-895-7840",
            "fax_number": "305-895-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615711",
            "telephone_number": "305-895-7840",
            "fax_number": "305-895-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH MIAMI MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "METELLUS",
        "authorized_official_first_name": "JEAN PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-895-7840"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "HCC4445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH MIAMI MEDICAL AND REHAB INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Family Medicine Physician in North Miami, FL
• Providers in North Miami, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.