NPIMap

Organization Active NPI

Sea Blue Neurology Center, PA

  • Neurology Physician
  • Coral Springs, FL
National Provider Identifier
1063527281
Registry record updated Jun 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME87897 Issued in FL
Legal business name
SEA BLUE NEUROLOGY CENTER, PA
Practice address
3100 Coral Hills Dr
Suite 308
Coral Springs, FL 33065-4137
Phone
(954) 796-9060
Fax
(954) 796-9061
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2010

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

Authorized official

Name
Ms. Janne Damas
Title
Office Manager
Phone
(954) 796-9060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X ME87897 FL Primary

Addresses

Primary practice location

3100 Coral Hills Dr
Suite 308
Coral Springs, FL 33065-4137

Mailing address

PO Box 25926
Tamarac, FL 33320
Phone (954) 796-9060

Other identifiers 5

IdentifierTypeStateIssuer
81087OtherBLUE CROSS BLUE SHIELD
7229240OtherCIGNA HEALTH CARE
1044955OtherCAREPLUS HEALTH PLAN
197019OtherAMERIGROUP
293244OtherAVMED HEALTH PLAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277683200000",
    "number": "1063527281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25926",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "33320",
            "telephone_number": "954-796-9060",
            "fax_number": "954-796-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CORAL HILLS DR",
            "address_2": "SUITE 308",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654137",
            "telephone_number": "954-796-9060",
            "fax_number": "954-796-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA BLUE NEUROLOGY CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-06-28",
        "status": "A",
        "authorized_official_last_name": "DAMAS",
        "authorized_official_first_name": "JANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-796-9060",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME87897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81087",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "7229240",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREPLUS HEALTH PLAN",
            "identifier": "1044955",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "197019",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED HEALTH PLAN",
            "identifier": "293244",
            "state": null
        }
    ],
    "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 Jun 28, 2010; 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.