NPIMap

Organization Active NPI

Dedicated Senior Medical Center of Florida, LLC

Doing business as Dedicated Senior Medical Center Monterey

  • Non-Pharmacy Dispensing Site
  • Jacksonville, FL
National Provider Identifier
1982375564
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED SENIOR MEDICAL CENTER OF FLORIDA, LLC
Doing business as
Dedicated Senior Medical Center Monterey
Practice address
1220 University Blvd N
Jacksonville, FL 32211-8852
Phone
(904) 490-8700
Fax
(904) 490-9810
NPI assigned
Sep 23, 2021
Last updated
Sep 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Mary Chen
Title
Authorized Offical
Phone
(305) 628-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

1220 University Blvd N
Jacksonville, FL 32211-8852

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

Other names 1

  • Dedicated Senior Medical Center Monterey Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2235799Dedicated Senior Medical Center Monterey1220 University Blvd N, Jacksonville, FL 32211Certificate of waiverSep 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Senior Medical Center of Florida LLC28 organizations share this tax ID, including this one
Part of
Dedicated Senior Medical Center of Florida LLC

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1982375564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 UNIVERSITY BLVD N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118852",
            "telephone_number": "904-490-8700",
            "fax_number": "904-490-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED SENIOR MEDICAL CENTER OF FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICAL",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center Monterey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.