Organization Active NPI

Primary Medical Care Inc

  • Clinic/Center
  • Miami, FL
National Provider Identifier
1982639100
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PRIMARY MEDICAL CARE INC
Practice address
3413 NW 17TH Ave
Miami, FL 33142-5537
Phone
(305) 635-1614
Fax
(305) 635-7476
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Orlando Avellaneda
Title
Owner
Phone
(305) 635-1614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3413 NW 17TH Ave
Miami, FL 33142-5537

Mailing address

3413 NW 17TH Ave
Miami, FL 33142-5537
Phone (305) 635-1614

Other identifiers 2

IdentifierTypeStateIssuer
268338500MedicaidFL
HCC4760OtherFLAHCA

National Provider Directory

National Provider Directory

Locations

3413 NW 17th Ave
Miami, FL 33142
Phone (305) 635-1614

Practitioners & affiliated clinicians

Practitioners 6

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": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1982639100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3413 NW 17TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331425537",
            "telephone_number": "305-635-1614",
            "fax_number": "305-635-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 NW 17TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331425537",
            "telephone_number": "305-635-1614",
            "fax_number": "305-635-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "AVELLANEDA",
        "authorized_official_first_name": "ORLANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-635-1614"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268338500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "HCC4760",
            "state": "FL"
        }
    ],
    "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 Sep 23, 2008; 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.