NPIMap

Organization Active NPI

Performance Orthopaedic

  • Specialist
  • Ft Lauderdale, FL
National Provider Identifier
1043462799
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PERFORMANCE ORTHOPAEDIC
Practice address
721 SE 17TH St
#104
Ft Lauderdale, FL 33316-2983
Phone
(954) 765-3200
Fax
(786) 975-2643
NPI assigned
Oct 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Authorized official

Name
Brian Mevorah
Title
Owner
Phone
(954) 765-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X FL Primary

Addresses

Primary practice location

721 SE 17TH St
#104
Ft Lauderdale, FL 33316-2983

Mailing address

721 SE 17TH St
#104
Ft Lauderdale, FL 33316-2983
Phone (954) 765-3200

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1043462799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 SE 17TH ST",
            "address_2": "#104",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162983",
            "telephone_number": "954-765-3200",
            "fax_number": "786-975-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 SE 17TH ST",
            "address_2": "#104",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162983",
            "telephone_number": "954-765-3200",
            "fax_number": "786-975-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE ORTHOPAEDIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "MEVORAH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-765-3200"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.