DEDICATED PENNSYLVANIA MAYFAIR
NPI 1477053569
Specialist in Philadelphia, PA

Q: What is Dedicated Pennsylvania Holding, LLC's NPI number?

The NPI number for Dedicated Pennsylvania Holding, LLC is 1477053569. It was assigned to this organization in the NPPES registry on February 15, 2018. The provider is doing business as Dedicated Pennsylvania Mayfair.

Q: What is Dedicated Pennsylvania Holding, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since February 15, 2018

6431 SACKETT ST, PHILADELPHIA, PA 19149(305) 628-6117(305) 363-5989 Get Directions Write a Review

NPPES record last updated: March 27, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 27, 2018, Feb 15, 2018 (2 updates tracked since 2018).

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About Dedicated Pennsylvania Mayfair NPPES

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

DEDICATED PENNSYLVANIA MAYFAIR (NPI 1477053569) is a healthcare organization registered as a specialist in Philadelphia, Pennsylvania and active in the NPI registry since February 2018. The organization lists Raymond Jimenez, Director Of Client Services, as its authorized official.

NPPES Registry Identity

NPI1477053569

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameDEDICATED PENNSYLVANIA HOLDING, LLC

Location Address6431 SACKETT STPhiladelphia, PA 19149-3118

Mailing Address1395 N.w/ 167th Street, Payer Enrollment DepartmentMiami Gardens, FL 33169 · (786) 870-4039 · Fax (786) 870-4039

Phone(305) 628-6117

Fax(305) 363-5989

Organization SubpartYesParent: Dedicated Pennsylvania Mayfair

Authorized OfficialRaymond JimenezDirector Of Client Services · (786) 870-4039

Enumeration DateFebruary 15, 2018

Last NPPES UpdateMarch 27, 20182 updates tracked since enumeration

✔ NPI 1477053569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X

Also ListedNon-Pharmacy Dispensing SiteTaxonomy 332900000X

6431 SACKETT ST, Philadelphia, PA 19149

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Other Names 1

Doing Business AsDedicated Pennsylvania Mayfair

Group Practice 2

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

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PETER RAJACIC

Internal Medicine