The Diabetic Place LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1956772 Issued in FL

Legal business name

THE DIABETIC PLACE LLC

Practice address

10472 Taft St
Pembroke Pines, FL 33026-2819

Phone

(954) 990-0461

Fax

(954) 990-0465

NPI assigned

Jun 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Shawna Charles, DNP

Title

Nurse Practitioner

Phone

(954) 990-0461

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 5

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

• Selwyn Bernard Carrington, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Pembroke Pines, FL
  • NPI 1841352739
  NPD (past)
• Brandon William Cornish, O.D.

  • Optometrist
  • Fort Lauderdale, FL
  • NPI 1396937470
  NPD (past)
• David John Heath, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Cooper City, FL
  • NPI 1053360099
  NPD (past)
• Ofelia D. Sanchez, OD

  • Optometrist
  • Hialeah, FL
  • NPI 1003995028
  NPD (past)
• John Vincent Williams, MD

  • Internal Medicine Physician
  • Hollywood, FL
  • NPI 1609863489
  NPD (past)

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1104022169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848182",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330840182",
            "telephone_number": "954-990-0461",
            "fax_number": "954-990-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10472 TAFT ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330262819",
            "telephone_number": "954-990-0461",
            "fax_number": "954-990-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DIABETIC PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "954-990-0461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "1956772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281108100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.