Organization Active NPI

Cardiovascular Clinic of East Fort Lauderdale LLC

  • Multi-Specialty Clinic/Center
  • Fort Lauderdale, FL
National Provider Identifier
1114606480
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CARDIOVASCULAR CLINIC OF EAST FORT LAUDERDALE LLC
Practice address
1925 NE 45TH St
Fort Lauderdale, FL 33308-5121
Phone
(954) 651-9847
NPI assigned
Jul 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Authorized official

Name
Kelly Bemis
Title
Chief Clinical Officer
Phone
(610) 644-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1925 NE 45TH St
Fort Lauderdale, FL 33308-5121

Mailing address

40 Valley Stream Pkwy Ste 100
Malvern, PA 19355-1407
Phone (610) 644-8900

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1114606480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 VALLEY STREAM PKWY STE 100",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551407",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 NE 45TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085121",
            "telephone_number": "954-651-9847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR CLINIC OF EAST FORT LAUDERDALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "BEMIS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "610-644-8900"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; 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.