NPIMap

Organization Active NPI

La Colonia Medical Center Inc

  • Health Service Clinic/Center
  • Cutler Bay, FL
National Provider Identifier
1851064653
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
LA COLONIA MEDICAL CENTER INC
Practice address
20453 Old Cutler Rd
Cutler Bay, FL 33189-1870
Phone
(305) 823-3312
Fax
(786) 360-2327
NPI assigned
Jul 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Yenin Acevedo, FMG
Title
President
Phone
(305) 608-1082

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

20453 Old Cutler Rd
Cutler Bay, FL 33189-1870

Mailing address

167 W 23Rd St
Hialeah, FL 33010-2211
Phone (305) 823-3312

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060428000280 FL Part B Supplier - Clinic/Group Practice 2264442607 Receives reassigned benefits from 12 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cutler Bay, FL; Tamarac, FL; Pembroke Pines, FL; North Miami, FL; Naranja, FL; Miami, FL; Hialeah, FL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2248984La Colonia Medical Center Inc20453 Old Cutler Rd, Cutler Bay, FL 33189Certificate of waiverJan 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
La Colonia Medical Center Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

20453 Old Cutler Rd
Cutler Bay, FL 33189

20595 Old Cutler Rd
Cutler Bay, FL 33189
Phone (305) 884-1744

901 E 10th Ave
Ste 34
Hialeah, FL 33010
Phone (786) 655-0730

27435 S Dixie Hwy
Naranja, FL 33032
Phone (305) 987-7823

8399 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 367-7439

10141 Pines Blvd
Pembroke Pines, FL 33026
Phone (305) 608-1082

6501 NW 36th St
Ste 413
Virginia Gardens, FL 33166
Phone (305) 871-8634

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1851064653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 W 23RD ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330102211",
            "telephone_number": "305-823-3312",
            "fax_number": "786-360-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20453 OLD CUTLER RD",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331891870",
            "telephone_number": "305-823-3312",
            "fax_number": "786-360-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA COLONIA MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "YENIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-608-1082",
        "authorized_official_credential": "FMG"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.