Organization Active NPI

Archetype Health LLC

  • Allergy & Immunology Physician
  • Coral Springs, FL
National Provider Identifier
1023840337
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
ARCHETYPE HEALTH LLC
Practice address
7663 W Sample Rd
Coral Springs, FL 33065-4718
Phone
(954) 906-3095
NPI assigned
Aug 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Arnaldo Perez, MDNPI 1306042908
Title
President
Phone
(954) 906-3095

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

7663 W Sample Rd
Coral Springs, FL 33065-4718

Mailing address

PO Box 266756
Weston, FL 33326-6756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241024000850 FL Part B Supplier - Clinic/Group Practice 1759814106 Receives reassigned benefits from 1 practitioner
Practice locations: Coral Springs, FL

National Provider Directory

National Provider Directory

Locations

7663 W Sample Rd
Coral Springs, FL 33065
Phone (954) 906-3095

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1023840337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 266756",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333266756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7663 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654718",
            "telephone_number": "954-906-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHETYPE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ARNALDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-906-3095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.