Coffeestone Holdings

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

COFFEESTONE HOLDINGS

Practice address

14505 Commerce Way Ste 800
Miami Lakes, FL 33016-1599

Phone

(305) 821-8861

Fax

(305) 821-8783

NPI assigned

Nov 13, 2018

Organization subpart

No

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

Authorized official

Name

Martel George Samuels, MD

Title

President

Phone

(361) 673-3111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1992273510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14505 COMMERCE WAY STE 800",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161599",
            "telephone_number": "305-821-8861",
            "fax_number": "305-821-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14505 COMMERCE WAY STE 800",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161599",
            "telephone_number": "305-821-8861",
            "fax_number": "305-821-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEESTONE HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "SAMUELS",
        "authorized_official_first_name": "MARTEL",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-673-3111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Coats
• Yamila Cobos Castillo
• Natacha Coca, ARNP
• Coconut Grove Recovery LLC
• Coconut Grove Recovery LLC
• Cognitive Health Network Corp
• Stefani Cohen, RNFA
• Schane Coker, M.S., FFC, AFC
• Collado Home Care Services Inc
• Ariadna Collazo, DPT

• Pediatrics Physician in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.