Organization Active NPI

Interactive Med-Unlim Surg Assist

  • Surgical Physician Assistant
  • Pompano Beach, FL
National Provider Identifier
1972863298
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
INTERACTIVE MED-UNLIM SURG ASSIST
Practice address
49 N Federal Hwy
Suite 361
Pompano Beach, FL 33062-4304
Phone
(954) 990-3515
NPI assigned
May 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Authorized official

Name
Miguel A Ortiz-Diaz, PACNPI 1780648253
Title
President
Phone
(954) 990-3515

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
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

49 N Federal Hwy
Suite 361
Pompano Beach, FL 33062-4304

Mailing address

49 N Federal Hwy
Suite 361
Pompano Beach, FL 33062-4304
Phone (954) 990-3515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120824000319 FL Part B Supplier - Clinic/Group Practice 3678720778 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL; Pompano Beach, FL; Pembroke Pines, FL; Miramar, FL; Miami, FL; Hollywood, FL; Hialeah, FL; Fort Lauderdale, FL

National Provider Directory

National Provider Directory

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": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1972863298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 N FEDERAL HWY",
            "address_2": "SUITE 361",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330624304",
            "telephone_number": "954-990-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 N FEDERAL HWY",
            "address_2": "SUITE 361",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330624304",
            "telephone_number": "954-990-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERACTIVE MED-UNLIM SURG ASSIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "ORTIZ-DIAZ",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-990-3515",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.