Organization Active NPI

Ocean Manor Professional Group LLC

  • Addiction Psychiatry Physician
  • Lauderdale by the Sea, FL
National Provider Identifier
1083155477
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
Legal business name
OCEAN MANOR PROFESSIONAL GROUP LLC
Practice address
4001 N Ocean Dr
Ste 305
Lauderdale by the Sea, FL 33308-5968
Phone
(844) 468-1345
Fax
(954) 856-2904
NPI assigned
Mar 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Authorized official

Name
Veronica Hernandez
Title
Manager
Phone
(954) 203-3584

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X Primary

Addresses

Primary practice location

4001 N Ocean Dr
Ste 305
Lauderdale by the Sea, FL 33308-5968

Mailing address

4001 N Ocean Dr
Ste 301
Lauderdale by the Sea, FL 33308-5968
Phone (844) 768-1345

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1083155477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 N OCEAN DR",
            "address_2": "STE 301",
            "city": "LAUDERDALE BY THE SEA",
            "state": "FL",
            "postal_code": "333085968",
            "telephone_number": "844-768-1345",
            "fax_number": "954-856-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 N OCEAN DR",
            "address_2": "STE 305",
            "city": "LAUDERDALE BY THE SEA",
            "state": "FL",
            "postal_code": "333085968",
            "telephone_number": "844-468-1345",
            "fax_number": "954-856-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN MANOR PROFESSIONAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-203-3584"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale by the Sea, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.