NPIMap

Organization Active NPI

Dedicated Senior Medical Centers of Florida, LLC

  • Non-Pharmacy Dispensing Site
  • Jacksonville, FL
National Provider Identifier
1902560089
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC
Practice address
8000-2 Lem Turner Road
Jacksonville, FL 32208
Phone
(904) 539-8200
Fax
(904) 539-8229
NPI assigned
Oct 26, 2021
Organization subpart
Yes
Parent organization
DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Authorized official

Name
Mary Chen
Title
Executive Officer
Phone
(305) 628-6117

Specialties & licenses 1

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

Addresses

Primary practice location

8000-2 Lem Turner Road
Jacksonville, FL 32208

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

Other names 1

  • Dedicated Senior Medical Center Lake Forest Hills Doing business as

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
10D2248011Dedicated Senior Medical Center8000-2 Lem Turner Rd, Jacksonville, FL 32208Certificate of waiverJan 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Senior Medical Center of Florida LLC28 organizations share this tax ID, including this one
Part of
Dedicated Senior Medical Center of Florida LLC

Other organizations with this tax ID 27

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

View all 27

Practitioners & affiliated clinicians

Practitioners 5

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": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1902560089",
    "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": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000-2 LEM TURNER ROAD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32208",
            "telephone_number": "904-539-8200",
            "fax_number": "904-539-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center Lake Forest Hills",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.