Family Physicians of Kendall LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME 81467 Issued in FL

Legal business name

FAMILY PHYSICIANS OF KENDALL LLC

Practice address

11160 SW 88TH St
Suite #104 & #105
Miami, FL 33176-0949

Phone

(786) 263-0911

Fax

(786) 263-2761

NPI assigned

Dec 27, 2007

Organization subpart

No

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

Authorized official

Name

Norma S Lake, M.D.NPI 1912906686

Title

Owner

Phone

(786) 263-0911

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• HealthSun Health Plans Network

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Norma Salenah Lake, MD

  • Family Medicine Physician
  • Miami, FL
  • NPI 1912906686
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1952585796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 SW 88TH ST",
            "address_2": "SUITE #104 & #105",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331760949",
            "telephone_number": "786-263-0911",
            "fax_number": "786-263-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 SW 88TH ST",
            "address_2": "SUITE #104 & #105",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331760949",
            "telephone_number": "786-263-0911",
            "fax_number": "786-263-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHYSICIANS OF KENDALL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-263-0911",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 81467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0637962",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080130460",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "01-03310",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151642",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000141284",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Miami, FL
• Providers in Miami, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.