Preventative Healthcare Management

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

PREVENTATIVE HEALTHCARE MANAGEMENT

Practice address

7342 NW 48TH St
Lauderhill, FL 33319-3401

Phone

(954) 471-3500

NPI assigned

Mar 7, 2019

Organization subpart

No

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

Authorized official

Name

Theona A Jackson, APRN

Title

President

Phone

(954) 471-3500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1124586243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7342 NW 48TH ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333193401",
            "telephone_number": "954-471-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7342 NW 48TH ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333193401",
            "telephone_number": "954-471-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTATIVE HEALTHCARE MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "THEONA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-471-3500",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Lauderhill, FL
• Providers in Lauderhill, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.