Active NPI
San Marcus Medical Office, Inc.
- Family Medicine Physician
- Hialeah, FL
National Provider Identifier
1821404104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME66961
- Legal business name
- SAN MARCUS MEDICAL OFFICE, INC.
- Practice address
- 5941 NW 173Rd Dr
Hialeah, FL 33015-5109 - Phone
- (786) 615-2713
- Fax
- (786) 615-3023
- NPI assigned
- Jul 7, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Idalia Acosta, MD
- Title
- President/Owner
- Phone
- (786) 615-2713
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME66961 | FL | Primary |
Addresses
Primary practice location
5941 NW 173Rd Dr
Hialeah, FL 33015-5109
Mailing address
5941 NW 173Rd Dr
Hialeah, FL 33015-5109
Phone (786) 615-2713
National Provider Directory
National Provider DirectoryLocations
5941 NW 173rd Dr
Hialeah, FL 33015
Phone (786) 615-2713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404691200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1404691200000",
"number": "1821404104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5941 NW 173RD DR",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330155109",
"telephone_number": "786-615-2713",
"fax_number": "786-615-3023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5941 NW 173RD DR",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330155109",
"telephone_number": "786-615-2713",
"fax_number": "786-615-3023"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAN MARCUS MEDICAL OFFICE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2014-07-07",
"last_updated": "2014-07-07",
"status": "A",
"authorized_official_last_name": "ACOSTA",
"authorized_official_first_name": "IDALIA",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "786-615-2713",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "FL",
"license": "ME66961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.