NPIMap

Organization Active NPI

South Florida Multi-Specialty Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Coral Gables, FL
National Provider Identifier
1982204616
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SOUTH FLORIDA MULTI-SPECIALTY MEDICAL GROUP LLC
Practice address
475 Biltmore Way Ste 205
Coral Gables, FL 33134-5736
Phone
(833) 735-3668
Fax
(866) 897-7014
NPI assigned
Oct 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Dr. Peter Hany Hanna, DPMNPI 1023465903
Title
Owner/Ceo
Phone
(973) 900-1198

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

475 Biltmore Way Ste 205
Coral Gables, FL 33134-5736

Mailing address

8950 SW 74TH CT Ste 1408
Miami, FL 33156-3173
Phone (833) 735-3668

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210215000097 FL Part B Supplier - Clinic/Group Practice 1052726510 Receives reassigned benefits from 11 practitioners
2 other NPIs on this enrollment
Practice locations: Homestead, FL; Miami, FL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 11

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": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1982204616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 SW 74TH CT STE 1408",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331563173",
            "telephone_number": "833-735-3668",
            "fax_number": "866-897-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BILTMORE WAY STE 205",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345736",
            "telephone_number": "833-735-3668",
            "fax_number": "866-897-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA MULTI-SPECIALTY MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-30",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "HANY",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "973-900-1198",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.