Physician Service Organization

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PHYSICIAN SERVICE ORGANIZATION

Practice address

9425 SW 72ND St
Suite 211
Miami, FL 33173-3251

Phone

(305) 263-1090

Fax

(305) 263-1091

NPI assigned

Apr 22, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Joel Lago

Title

President

Phone

(305) 263-1090

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271894400000",
    "number": "1891012472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9425 SW 72NS STREET",
            "address_2": "SUITE 211",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33173",
            "telephone_number": "305-263-1090",
            "fax_number": "305-263-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9425 SW 72ND ST",
            "address_2": "SUITE 211",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733251",
            "telephone_number": "305-263-1090",
            "fax_number": "305-263-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN SERVICE ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-22",
        "last_updated": "2010-04-22",
        "status": "A",
        "authorized_official_last_name": "LAGO",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-263-1090",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Miami, FL
• Providers in Miami, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.