Primary Care Physicians of Hollywood, PL

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIMARY CARE PHYSICIANS OF HOLLYWOOD, PL

Practice address

2488 N University Dr
Pembroke Pines, FL 33024-3624

Phone

(954) 983-9191

Fax

(954) 983-1152

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Laura Burke

Title

Credentialing Manger

Phone

(954) 563-4472

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1053362665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243624",
            "telephone_number": "954-983-9191",
            "fax_number": "954-983-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243624",
            "telephone_number": "954-983-9191",
            "fax_number": "954-983-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PHYSICIANS OF HOLLYWOOD, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CREDENTIALING MANGER",
        "authorized_official_telephone_number": "954-563-4472"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 74548",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 81676",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "39480",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269366600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Prieto Souto, BCBA
• Addys Prieto, PSY.D.
• Evelyn Prieto, DMD
• Primary Care LLC
• Primary Care Physicians of Hollywood, PA
• Primary Care Physicians of Hollywood, PL
• Primary Care Physicians of West Broward PA
• Primary Care Providers of America, LLC (South Florida Inpatient Associates)
• Primary Medical Physicians, LLC
• Primecare Medical Services LLC

• Internal Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.