Organization Active NPI

Familia Health Clinic LLC

  • Family Medicine Physician
  • Deerfield Beach, FL
National Provider Identifier
1164035861
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILIA HEALTH CLINIC LLC
Practice address
450 W Hillsboro Blvd
Deerfield Beach, FL 33441-1604
Phone
(954) 531-0461
Fax
(954) 531-0713
NPI assigned
Aug 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Authorized official

Name
Arthur Soderberg
Title
Cfo
Phone
(954) 531-0461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

450 W Hillsboro Blvd
Deerfield Beach, FL 33441-1604

Mailing address

450 W Hillsboro Blvd
Deerfield Beach, FL 33441-1604
Phone (954) 531-0461

Other identifiers 1

IdentifierTypeStateIssuer
12398OtherFLAHCA LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201006001227 FL Part B Supplier - Clinic/Group Practice 9830518182 Receives reassigned benefits from 2 practitioners
Practice locations: Deerfield Beach, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2191640Familia Health Clinic, LLC450 W Hillsboro Blvd, Deerfield Beach, FL 33441Certificate of waiverAug 30, 2026

National Provider Directory

National Provider Directory

Locations

1644 W Hillsboro Blvd
Deerfield Beach, FL 33442
Phone (561) 531-0713

Practitioners & affiliated clinicians

Practitioners 4

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": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1164035861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W HILLSBORO BLVD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411604",
            "telephone_number": "954-531-0461",
            "fax_number": "954-531-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W HILLSBORO BLVD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411604",
            "telephone_number": "954-531-0461",
            "fax_number": "954-531-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILIA HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "SODERBERG",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "954-531-0461"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA LICENSE",
            "identifier": "12398",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.