NPIMap

Organization Active NPI

Caremax Medical Center of Broward LLC

  • Primary Care Clinic/Center
  • Plantation, FL
National Provider Identifier
1871937987
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CAREMAX MEDICAL CENTER OF BROWARD LLC
Practice address
4302 W Broward Blvd
Plantation, FL 33317-3780
Phone
(954) 644-8902
Fax
(877) 967-5710
NPI assigned
Apr 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Carlos De Solo
Title
Chief Executive Officer
Phone
(305) 649-8100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Point of Service 305S00000X

Addresses

Primary practice location

4302 W Broward Blvd
Plantation, FL 33317-3780

Mailing address

1000 NW 57TH CT Ste 400
Miami, FL 33126-3292
Phone (305) 649-8100

Other practice location 1

3880 W Broward Blvd
B4 - B7
Fort Lauderdale, FL 33312-1058
Phone (954) 644-8902

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160411001049 FL Part B Supplier - Clinic/Group Practice 5496053340 Receives reassigned benefits from 7 practitioners
4 other NPIs on this enrollment
Practice locations: Deerfield Beach, FL; Fort Lauderdale, FL; Plantation, FL; Pompano Beach, FL

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Caremax Medical Center of Broward LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

3880 W Broward Blvd
#B4
Fort Lauderdale, FL 33312
Phone (954) 644-8902

Ownership & related parties

Subparts reporting this organization as parent 5

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

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": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1871937987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NW 57TH CT STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263292",
            "telephone_number": "305-649-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333173780",
            "telephone_number": "954-644-8902",
            "fax_number": "877-967-5710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3880 W Broward Blvd",
            "address_2": "B4 - B7",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333121058",
            "country_code": "US",
            "telephone_number": "954-644-8902",
            "fax_number": "877-967-5710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAREMAX MEDICAL CENTER OF BROWARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "DE SOLO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "305-649-8100"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.