Institute of Preventive Medicine, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ARNP3081082 Issued in FL

Legal business name

INSTITUTE OF PREVENTIVE MEDICINE, LLC

Practice address

1275 W 47TH PL
Suite 422
Hialeah, FL 33012-3394

Phone

(305) 676-2300

Fax

(888) 601-0076

NPI assigned

Mar 29, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Otniel Hernandez, DNP

Title

Ceo

Phone

(305) 676-2300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493769600000",
    "number": "1902195191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 W 47TH PL",
            "address_2": "SUITE 422",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123394",
            "telephone_number": "305-676-2300",
            "fax_number": "888-601-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 W 47TH PL",
            "address_2": "SUITE 422",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123394",
            "telephone_number": "305-676-2300",
            "fax_number": "888-601-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF PREVENTIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2017-05-03",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "OTNIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-676-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ARNP3081082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308614300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.