Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dedicated Pennsylvania Holding, LLC

Organization Specialist · NPI 1477053569

Dedicated Pennsylvania Holding, LLC is a Specialist in Philadelphia, Pennsylvania. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6431 Sackett St
Philadelphia, PA 19149-3118
Phone: (305) 628-6117
Fax: (305) 363-5989
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X
Internal Medicine Physician Taxonomy 207R00000X
Primary Care Clinic/Center Taxonomy 261QP2300X
Non-Pharmacy Dispensing Site Taxonomy 332900000X

Record details

NPI number1477053569
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationDedicated Pennsylvania Mayfair
Authorized official Raymond Jimenez — Director Of Client Services · (786) 870-4039
Other names Dedicated Pennsylvania Mayfair; Dedicated Pennsylvania Mayfair
NPI enumeratedFebruary 15, 2018
Last updated in NPPESMarch 27, 2018
Mailing address1395 N.W/ 167th Street, Payer Enrollment Department, Miami Gardens, FL 33169

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