ILLUMINA MEDICAL GROUP SPECIALTY, LLC
NPI 1437667078
Clinic/Center in Doral, FL

NPI Status: Active since January 17, 2018

Contact Information

1914 NW 84TH AVE
DORAL, FL
ZIP 33126
Phone: (305) 254-8900
Fax: (305) 254-8902

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Group Taxonomy
Insurance Plans Accepted
Authorized Official
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Clinic/Center

About ILLUMINA MEDICAL GROUP SPECIALTY, LLC

This page provides the complete NPI Profile along with additional information for Illumina Medical Group Specialty, Llc, a provider established in Doral, Florida operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1437667078 assigned on January 2018. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Mr. Angel Andres Mongeotti (Executive Director Of Finance)

NPI: 1437667078
Provider Name: ILLUMINA MEDICAL GROUP SPECIALTY, LLC
Entity Type: Organization
Location Address: 1914 NW 84TH AVE DORAL, FL 33126
Location Phone: (305) 254-8900
Location Fax: (305) 254-8902
Mailing Address: 1914 NW 84TH AVE DORAL, FL 33126
Mailing Phone: (305) 254-8900
Mailing Fax: (305) 254-8902
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 01-17-2018
Last Update Date: 07-27-2018
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Clinic/Center
Taxonomy Code: 261Q00000X
Type: Ambulatory Health Care Facilities
Taxonomy Description: A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization
1	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine
2	261QM1300X	Ambulatory Health Care Facilities	Clinic/Center Multi-Specialty
3	261QM2500X	Ambulatory Health Care Facilities	Clinic/Center Medical Specialty

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: MR. ANGEL ANDRES MONGEOTTI
Authorized Official Title: EXECUTIVE DIRECTOR OF FINANCE
Authorized Official Phone: (305) 254-8900

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
L17000260851	OTHER (01)	FL	STATE DOCUMENT NUMBER

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	4	3	7	6	6	7	0	7	8
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	4	6	7	12	6	14	0	14
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 6 + 7 + 1 + 2 + 6 + 1 + 4 + 0 + 1 + 4 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 8									8

The NPI number 1437667078 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.