NPIMap

Organization Active NPI

Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
National Provider Identifier
1881055366
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DEDICATED SENIOR MEDICAL CENTER OF FLORIDA, LLC
Practice address
1395 NW 167TH St
Miami Gardens, FL 33169-5742
Phone
(305) 628-6117
NPI assigned
Mar 11, 2016
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mary Chen
Title
Authorized Official
Phone
(305) 831-4722

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary
Non-Pharmacy Dispensing Site 332900000X

Addresses

Primary practice location

1395 NW 167TH St
Miami Gardens, FL 33169-5742

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5742

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161101001703 FL Part B Supplier - Clinic/Group Practice 4486932100 Receives reassigned benefits from 327 practitioners
6 other NPIs on this enrollment
Practice locations: Tampa, FL; Winter Park, FL; Temple Terrace, FL; St Petersburg, FL; Riviera Beach, FL; Orlando, FL; Largo, FL; Clearwater, FL…

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Locations

1505 53rd Ave E
Bradenton, FL 34203
Phone (941) 357-7950

5848 Atlantic Ave
Delray Beach, FL 33484
Phone (561) 270-6950

11600 Gladiolus Dr
Ste C17
Fort Myers, FL 33908
Phone (239) 790-2488

4990 Majorca Palms Dr
Fort Myers, FL 33905
Phone (239) 990-3144

3614 Blanding Blvd
Jacksonville, FL 32210
Phone (904) 419-7100

8000 Lem Turner Rd
Jacksonville, FL 32208
Phone (904) 539-8200

8000 Lem Turner Rd
#2
Jacksonville, FL 32208
Phone (904) 539-8200

4390 66th St N
Kenneth City, FL 33709
Phone (727) 513-4100

105 S Florida Ave
#3
Lakeland, FL 33801

105 S Florida Ave
Fl 3
Lakeland, FL 33801
Phone (863) 777-2443

4715 S Florida Ave
Ste 200
Lakeland, FL 33813
Phone (863) 209-7004

890 Missouri Ave N
Largo, FL 33770
Phone (727) 739-8200

2724 N Hiawassee Rd
Ste 100
Orlando, FL 32818
Phone (407) 906-0082

4636 S Orange Blossom Trl
Orlando, FL 32839

3002 Broadway
Riviera Beach, FL 33404
Phone (561) 331-4844

2805 54th Ave N
Ste 500
St Petersburg, FL 33714
Phone (727) 341-5800

9501 Anderson Rd
Tampa, FL 33634
Phone (813) 413-7333

8727 Temple Terrace Hwy
Temple Terrace, FL 33637
Phone (813) 796-5400

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 352

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 352

NPI Registry JSON

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1881055366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695742",
            "telephone_number": "305-628-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED SENIOR MEDICAL CENTER OF FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-831-4722"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.