St Jude Medical Group Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ST JUDE MEDICAL GROUP CORP

Doing business as

Vidamax Medical Center

Practice address

2141 NW 7TH St
Miami, FL 33125-3483

Phone

(786) 464-5120

Fax

(786) 464-5125

NPI assigned

Apr 25, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Manuel D Gonzalez, M.D.NPI 1356584361

Title

President

Phone

(786) 464-5120

Specialties & licenses 1

Addresses

Other names 1

• VIDAMAX MEDICAL CENTER Doing business as

Tax ID family

St Jude Medical Group Corp6 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.

• St Jude Medical Group Corp

  dba Vidamax Medical Center

  • Clinic/Center
  • Miami, FL
  • NPI 1336965342
  NPD tax ID
• St Jude Medical Group Corp

  dba Vidamax Medical Center

  • Clinic/Center
  • Hollywood, FL
  • NPI 1356167365
  NPD tax ID
• St Jude Medical Group Corp

  dba Vidamax Medical Center

  • Clinic/Center
  • Hollywood, FL
  • NPI 1760208771
  NPD tax ID
• St Jude Medical Group Corp

  dba Vidamax Medical Center

  • Clinic/Center
  • Miami, FL
  • NPI 1831915842
  NPD tax ID
• St Jude Medical Group Corp

  dba Vidamax Medical Center

  • Clinic/Center
  • Hialeah Gardens, FL
  • NPI 1982420998
  NPD tax ID

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, and the practitioner matching its NPPES authorized official.

• Manuel D. Gonzalez, MD

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1356584361
  NPD (past) Authorized official

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

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1952745580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 NW 7TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331253483",
            "telephone_number": "786-464-5120",
            "fax_number": "786-464-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 NW 7TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331253483",
            "telephone_number": "786-464-5120",
            "fax_number": "786-464-5125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11300 NW 87th Ct Ste 141",
            "address_purpose": "LOCATION",
            "city": "Hialeah Gardens",
            "state": "FL",
            "postal_code": "330184520",
            "country_code": "US",
            "telephone_number": "786-464-5120",
            "fax_number": "786-464-5125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2040 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330206930",
            "country_code": "US",
            "telephone_number": "754-348-5001",
            "fax_number": "786-464-5125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1127 NW 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331252738",
            "country_code": "US",
            "telephone_number": "786-464-5120",
            "fax_number": "786-464-5125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6109 Pembroke Rd",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330232213",
            "country_code": "US",
            "telephone_number": "954-239-7054",
            "fax_number": "786-464-5125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10522 SW 8th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331742602",
            "country_code": "US",
            "telephone_number": "786-464-5120",
            "fax_number": "786-464-5125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST JUDE MEDICAL GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-464-5120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIDAMAX MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VIDAMAX MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St Jude Med and Rehab Care Inc
• St Jude Medical Center Inc
• St Jude Medical Equipment Corp
• St Jude Medical Group Corp (Vidamax Medical Center)
• St Jude Medical Group Corp (Vidamax Medical Center)
• Vasthie St Juste, PHARMACIST, PHARM.D.
• St Mary Adult Care
• St Moses Pharmacy Corp
• Joan Elizabeth St Onge, M.D.
• Theresa Gloria St Philippe, ARNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.