Active NPI
Advanced Medical Treatment Center of Broward, LLC
- Clinic/Center
- Fort Lauderdale, FL
National Provider Identifier
1063132322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- ADVANCED MEDICAL TREATMENT CENTER OF BROWARD, LLC
- Practice address
- 2425 E Commercial Blvd Ste 300
Ft Lauderdale, FL 33308-4003 - Phone
- (954) 616-8905
- Fax
- (954) 616-8906
- NPI assigned
- Aug 29, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Barbara Alfaro, RN
- Title
- Owner
- Phone
- (305) 967-4611
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
2425 E Commercial Blvd Ste 300
Ft Lauderdale, FL 33308-4003
Mailing address
2425 E Commercial Blvd Ste 300
Ft Lauderdale, FL 33308-4003
Phone (954) 616-8905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221011000873 | FL | Part B Supplier - Mass Immunization (Roster Biller Only) | 3476939752 | Practice locations: Ft Lauderdale, FL |
National Provider Directory
National Provider DirectoryLocations
2425 E Commercial Blvd
Ste 300
Ft Lauderdale, FL 33308
Phone (305) 333-4897
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661731200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661731200000",
"number": "1063132322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 E COMMERCIAL BLVD STE 300",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333084003",
"telephone_number": "954-616-8905",
"fax_number": "954-616-8906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 E COMMERCIAL BLVD STE 300",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333084003",
"telephone_number": "954-616-8905",
"fax_number": "954-616-8906"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED MEDICAL TREATMENT CENTER OF BROWARD, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-08-29",
"last_updated": "2022-08-29",
"certification_date": "2022-08-29",
"status": "A",
"authorized_official_last_name": "ALFARO",
"authorized_official_first_name": "BARBARA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "305-967-4611",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.