NPIMap

Organization Active NPI

Seminole Tribe of Florida Health Dept.

  • Primary Care Clinic/Center
  • Hollywood, FL
National Provider Identifier
1144551748
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SEMINOLE TRIBE OF FLORIDA HEALTH DEPT.
Practice address
3006 Josie Billie Ave
Hollywood, FL 33024
Phone
(954) 962-2009
Fax
(954) 985-8456
NPI assigned
Jan 21, 2010
Last updated
Jan 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Authorized official

Name
Connie Whidden, MSW
Title
Health Director Seminole Tribe of F
Phone
(954) 962-2009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federal Public Health Clinic/Center 261QP0904X 3083592 FL
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

3006 Josie Billie Ave
Hollywood, FL 33024

Mailing address

3006 Josie Billie Ave.
Hollywood, FL 33024
Phone (954) 262-2009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210817002167 TX Part B Supplier - Clinic/Group Practice 4082710835 Receives reassigned benefits from 15 practitioners
3 other NPIs on this enrollment
Practice locations: Clewiston, FL; Hollywood, FL; Immokalee, FL; Okeechobee, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3006 Josie Billie Ave
Hollywood, FL 33024
Phone (954) 962-2009

1120 S 1st St
Immokalee, FL 34142
Phone (239) 867-3400

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1144551748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 JOSIE BILLIE AVE.",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-262-2009",
            "fax_number": "954-985-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 JOSIE BILLIE AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-962-2009",
            "fax_number": "954-985-8456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMINOLE TRIBE OF FLORIDA HEALTH DEPT.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "WHIDDEN",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "HEALTH DIRECTOR SEMINOLE TRIBE OF F",
        "authorized_official_telephone_number": "954-962-2009",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": "FL",
            "license": "3083592",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.