NPIMap

Organization Active NPI

Promed Healthcare Clinic LLC

  • Nurse Practitioner
  • Miami, FL
National Provider Identifier
1942949649
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PROMED HEALTHCARE CLINIC LLC
Practice address
11400 W Flagler St Ste 202
Miami, FL 33174-4007
Phone
(305) 548-1118
Fax
(786) 558-5697
NPI assigned
Jun 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Authorized official

Name
Magaly TraviesoNPI 1508343492
Title
Owner
Phone
(305) 639-8095

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

11400 W Flagler St Ste 202
Miami, FL 33174-4007

Mailing address

11400 W Flagler St Ste 202
Miami, FL 33174-4007
Phone (305) 548-1118

National Provider Directory

National Provider Directory
Tax ID family
Promed Healthcare Clinic 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

11400 W Flagler St
Ste 202
Miami, FL 33174
Phone (305) 548-1118

Practitioners & affiliated clinicians

Practitioners 1

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": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1942949649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11400 W FLAGLER ST STE 202",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331744007",
            "telephone_number": "305-548-1118",
            "fax_number": "786-558-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 W FLAGLER ST STE 202",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331744007",
            "telephone_number": "305-548-1118",
            "fax_number": "786-558-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED HEALTHCARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-01",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "TRAVIESO",
        "authorized_official_first_name": "MAGALY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-639-8095"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.