Organization Active NPI

Medimore MD LLC

  • Internal Medicine Physician
  • Wellington, FL
National Provider Identifier
1861167686
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDIMORE MD LLC
Practice address
12797 Forest Hill Blvd Ste B
Wellington, FL 33414-4763
Phone
(561) 467-5232
Fax
(561) 461-1320
NPI assigned
Aug 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Authorized official

Name
Juan F. Zapata, MDNPI 1184668618
Title
Managing Member
Phone
(239) 470-5539

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12797 Forest Hill Blvd Ste B
Wellington, FL 33414-4763

Mailing address

12797 Forest Hill Blvd Ste B
Wellington, FL 33414-4763
Phone (561) 467-5232

Other practice location 1

6334 Forest Hill Blvd Ste 334
Greenacres, FL 33415-6104
Phone (561) 467-5232

Other names 1

  • MEDIMORE MD Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Wellington Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220406001346 FL Part B Supplier - Clinic/Group Practice 5991191611 Receives reassigned benefits from 2 practitioners
Practice locations: Wellington, FL

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
10D2255577Medimore MD LLC12797 Forest Hill Boulevard Site B, Wellington, FL 33414Certificate of waiverMar 15, 2028
10D2324079Medimore MD LLC6334 Forest Hill Blvd Suite 334, Green Acres, FL 33415Certificate of waiverMay 18, 2027

National Provider Directory

National Provider Directory

Locations

6334 Forest Hill Blvd
Ste 334
Greenacres, FL 33415
Phone (561) 467-5232

7070 Seminole Pratt Whitney Rd
Ste 5
Loxahatchee, FL 33470
Phone (561) 467-5232

Practitioners & affiliated clinicians

Practitioners 2

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": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1861167686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12797 FOREST HILL BLVD STE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144763",
            "telephone_number": "561-467-5232",
            "fax_number": "561-461-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12797 FOREST HILL BLVD STE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144763",
            "telephone_number": "561-467-5232",
            "fax_number": "561-461-1320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6334 Forest Hill Blvd Ste 334",
            "address_purpose": "LOCATION",
            "city": "Greenacres",
            "state": "FL",
            "postal_code": "334156104",
            "country_code": "US",
            "telephone_number": "561-467-5232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDIMORE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-13",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "ZAPATA",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "239-470-5539",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Wellington",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Wellington",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12797 Forest Hill Blvd Ste B",
            "city": "Wellington",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334144763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MEDIMORE MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.