NPIMap

Organization Active NPI

PCP of Pembroke Pines

  • Family Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1033248190
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PCP OF PEMBROKE PINES
Practice address
1 SW 129TH Ave
Suite 109
Pembroke Pines, FL 33027-1761
Phone
(954) 433-4200
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Peter Anzalone
Title
Director
Phone
(954) 318-6590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1 SW 129TH Ave
Suite 109
Pembroke Pines, FL 33027-1761

Mailing address

1 SW 129TH Ave
Suite 109
Pembroke Pines, FL 33027-1761
Phone (954) 433-4200

National Provider Directory

National Provider Directory
Tax ID family
PCP of Lauderdale Lakes2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1033248190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SW 129TH AVE",
            "address_2": "SUITE 109",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271761",
            "telephone_number": "954-433-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SW 129TH AVE",
            "address_2": "SUITE 109",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271761",
            "telephone_number": "954-433-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCP OF PEMBROKE PINES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ANZALONE",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "954-318-6590",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.