SOUTH MIAMI DENTAL SERVICE PA (NPI# 1104274471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104274471 |
| Entity Type | Organization |
| Organization Name | SOUTH MIAMI DENTAL SERVICE PA |
| Other Organization Name | ILLUSTRADENT KEY BISCAYNE |
| Practice Address |
240 Crandon Blvd Suite 104 Key Biscayne FL 33149 |
| Practice Telephone | 3053610351 |
| Practice Fax Number | 3053612180 |
| Mailing Telephone | 3056615360 |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |
| Authorized Official Name | MAYRA V PEREZ (ADMNISTRATOR) |
| Authorized Official Telephone | 3053615493 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 302R00000X | Health Maintenance Organization | DN18909 | FL | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| Illustradent key biscayne | Doing Business As Name - Organization |
| Street Address |
240 CRANDON BLVD SUITE 104 |
| City | KEY BISCAYNE |
| State | FL |
| Zip Code | 33149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821003229 | Key Biscayne Associates In Pediatrics Pa | Specialist | 240 Crandon Blvd, Suite 106, Key Biscayne, FL 33149-1543 | 2006-07-31 |
| 1164908604 | Kelsey Taylor Hartmann | Nurse Practitioner | 240 Crandon Blvd, Ste 212, Key Biscayne, FL 33149 | 2018-07-18 |
| 1174023394 | Orlando Victor Rodriguez Jr. | Psychologist | 240 Crandon Blvd, Key Biscayne, FL 33149-1543 | 2018-02-14 |
| 1417467556 | Bobes Psychiatry, LLC | Psychiatry & Neurology | 240 Crandon Blvd, Key Biscayne, FL 33149-1543 | 2017-10-03 |
| 1487010245 | Jose Luis Chaviano Jr. | Dentist | 240 Crandon Blvd, Suite 104, Key Biscayne, FL 33149-1543 | 2016-01-11 |
| 1114305018 | Illustradent Key Biscayne Pllc | Dentist | 240 Crandon Blvd, Suite 104, Key Biscayne, FL 33149-1543 | 2015-05-11 |
| 1912308172 | Christopher Altieri | Physical Therapist | 240 Crandon Blvd, Suite 202, Key Biscayne, FL 33149-1543 | 2014-09-08 |
| 1528479557 | Javier Obregon | Clinic/Center | 240 Crandon Blvd, Suite 202, Key Biscayne, FL 33149 | 2014-05-13 |
| 1700153988 | Key Biscayne Physical Therapy L.L.C. | Physical Therapist | 240 Crandon Blvd, Suite 202, Key Biscayne, FL 33149-1543 | 2011-11-16 |
| 1528348364 | Jean Pierre Chacon, Pa | Clinic/Center | 240 Crandon Blvd, Suite 207, Key Biscayne, FL 33149-1543 | 2011-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629529433 | Manuel Alvarez Jacinto | Physician Assistant | 240 Crandon Blvd Ste 110, Key Biscayne, FL 33149 | 2016-10-17 |
| 1578012407 | Lidia Rubio | Marriage & Family Therapist | 181 Crandon Blvd, Apt 307, Key Biscayne, FL 33149 | 2016-10-04 |
| 1396138608 | Key Biscayne Pediatrics, P.a . / Jorge L. Bertran, Md. | Pediatrics | 604 Crandon Boulevard, Suite 202, Key Biscayne, FL 33149 | 2015-03-11 |
| 1679878615 | Herbert Kean | Otolaryngology | 799 Crandon Blvd, Apt 1407, Key Biscayne, FL 33149 | 2011-01-24 |
| 1922315399 | Glenn Meyer Abrahmsohn | Dentist | 260 Crandon Blvd., Suite 31, Key Biscayne, FL 33149 | 2010-09-08 |
| 1629218292 | Chia Ling Chow-watson | Massage Therapist | 455 Grand Bay Dr., Key Biscayne, FL 33149 | 2009-02-23 |
| 1750580668 | Neil Friedman | Dentist | 969 Crandon Blvd, Key Biscayne, FL 33149 | 2007-07-12 |
| 1144321829 | Carmen J. Ortiz-butcher | Internal Medicine | 971 Crandon Blvd, Suite 967, Key Biscayne, FL 33149 | 2006-09-26 |
| 1376646802 | Michael Lawrence Landau | Optometrist | 260 Crandon Blvd, Suite 44, Key Biscayne, FL 33149 | 2006-09-07 |
| 1518922004 | Khouri Laboratories, Inc | Dermatology | 180 Crandon Blvd, Ste #114, Key Biscayne, FL 33149 | 2006-04-19 |
| Find all providers in zip 33149 | ||||
| Taxonomy Code | 302R00000X |
| Grouping | Managed Care Organizations |
| Classification | Health Maintenance Organization |
| (1) A form of health insurance in which its members prepay a premium for the HMO’s health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58 |
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| Find all providers with the same taxonomy | ||||
| City | KEY BISCAYNE |
| Zip Code | 33149 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.