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UNIVIDA HALLANDALE MEDICAL CENTER LLC
NPI 1366015042
Family Medicine - Adult Medicine in Hallandale Beach, FL

Active since July 21, 2021CLIA 10D2233282 · Waiver
2500 E HALLANDALE BEACH BLVD STE QR, HALLANDALE BEACH, FL 33009(954) 505-5009(786) 677-0104 Get Directions Write a Review

NPPES record last updated: September 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 16, 2024, Jul 21, 2021 (2 updates tracked since 2021).

About Univida Hallandale Medical Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UNIVIDA HALLANDALE MEDICAL CENTER LLC (NPI 1366015042) is a healthcare organization registered as an adult medicine in Hallandale Beach, Florida and active in the NPI registry since July 2021. The organization holds a CLIA Waiver certificate valid through August 22, 2027 and lists Hermann J Lange, Sr Mem, as its authorized official.

NPPES Registry Identity

NPI1366015042
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameUNIVIDA HALLANDALE MEDICAL CENTER LLC
Location Address2500 E HALLANDALE BEACH BLVD STE QRHallandale Beach, FL 33009-4834
Mailing Address2500 E Hallandale Beach Blvd Ste QrHallandale Beach, FL 33009-4834 · (954) 505-5009 · Fax (786) 677-0104
Phone(954) 505-5009
Fax(786) 677-0104
Organization SubpartNo
Authorized OfficialHermann J LangeSr Mem · (954) 505-5009
Enumeration DateJuly 21, 2021
Last NPPES UpdateSeptember 16, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2024
✔ NPI 1366015042 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
2500 E HALLANDALE BEACH BLVD STE QR, Hallandale Beach, FL 33009
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Univida Hallandale Medical Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Univida Hallandale Medical Center LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Douglas Aguirre, MD
Anesthesiology
NPI 1376516880
2500 E HALLANDALE BEACH BLVD STE QR
Hallandale Beach, FL 33009
(954) 505-5009
✔ PECOS✔ Accepts MedicareSame address
Ariel Amador Gonzalez, FNP
Nurse Practitioner
NPI 1154195766
2500 E HALLANDALE BEACH BLVD STE QR
Hallandale Beach, FL 33009
(954) 505-5009
✔ PECOS✔ Accepts MedicareSame address
Thomas Marin, NURSE PRACTITIONER
Nurse Practitioner
NPI 1215306782
2500 E HALLANDALE BEACH BLVD STE QR
Hallandale Beach, FL 33009
(954) 505-5609
✔ PECOS✔ Accepts MedicareSame address
Ruben Bembibre, APRN
Nurse Practitioner
NPI 1689962672
2500 E HALLANDALE BEACH BLVD STE QR
Hallandale Beach, FL 33009
(954) 505-5009
✔ PECOS✔ Accepts MedicareSame address
Osmel Suarez, FNP-C
Nurse Practitioner
NPI 1659101020
995 N MIAMI BEACH BLVD
North Miami Beach, FL 33162
(786) 785-5900
✔ PECOS✔ Accepts Medicare5.3 mi
Sergio Hernandez Borges
Internal Medicine
NPI 1043600414
8752 NW 157TH TER
Miami Lakes, FL 33018
(305) 439-2281
✔ PECOS✔ Accepts Medicare14 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2233282

Univida Hallandale Medical Center, LLC · Hallandale Beach, FL
Active · expires Aug 22, 2027
CLIA Number10D2233282
Laboratory TypePhysician Office
Certificate Effective DateAugust 23, 2025
Certificate Expiration DateAugust 22, 2027
Laboratory DirectorRuben Bembibre
Laboratory Phone(954) 505-5009
Laboratory LocationUnivida Hallandale Medical Center, LLC2500 E Hallandale Beach Blvd, Suite Q, Hallandale Beach, FL 33009
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Univida Hallandale Medical Center LLC's NPI number?

The NPI number for Univida Hallandale Medical Center LLC is 1366015042. It was assigned to this organization in the NPPES registry on July 21, 2021.

Where is Univida Hallandale Medical Center LLC located?

Univida Hallandale Medical Center LLC is located at 2500 E Hallandale Beach Blvd Ste Qr, Hallandale Beach, FL 33009. The listed phone number is (954) 505-5009.

What is Univida Hallandale Medical Center LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Univida Hallandale Medical Center LLC enrolled in Medicare?

Yes. Univida Hallandale Medical Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Univida Hallandale Medical Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Univida Hallandale Medical Center LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4), Anesthesiology (1) and Internal Medicine (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Univida Hallandale Medical Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2233282) is associated with this NPI, valid through August 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Univida Hallandale Medical Center LLC was last updated on September 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.