Organization Active NPI

Florida Medical Care Group Corp

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1962152181
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
FLORIDA MEDICAL CARE GROUP CORP
Practice address
13190 SW 134TH St Ste 108
Miami, FL 33186-4460
Phone
(786) 768-1283
Fax
(786) 364-7154
NPI assigned
Mar 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Marilyn Betancourt, APRNNPI 1588127856
Title
President
Phone
(786) 768-1283

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
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

13190 SW 134TH St Ste 108
Miami, FL 33186-4460

Mailing address

13190 SW 134TH St Ste 108
Miami, FL 33186-4460
Phone (786) 768-1283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220426000376 FL Part B Supplier - Clinic/Group Practice 7911394796 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

13190 SW 134th St
Ste 108
Miami, FL 33186
Phone (786) 768-1283

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": "1648512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1962152181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13190 SW 134TH ST STE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864460",
            "telephone_number": "786-768-1283",
            "fax_number": "786-364-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13190 SW 134TH ST STE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864460",
            "telephone_number": "786-768-1283",
            "fax_number": "786-364-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MEDICAL CARE GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "BETANCOURT",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-768-1283",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "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 Mar 29, 2022; 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.