NPIMap

Organization Active NPI

Floridamedcare

  • Internal Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1205897667
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME39359 Issued in FL
Legal business name
FLORIDAMEDCARE
Practice address
1576 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5450
Phone
(772) 337-4578
NPI assigned
Mar 28, 2006
Last updated
Oct 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
Dr. Manjula Nayyar, M.D.NPI 1467405506
Title
Physician
Phone
(772) 342-6911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME39359 FL Primary
Pulmonary Disease Physician 207RP1001X ME30367 FL

Addresses

Primary practice location

1576 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5450

Mailing address

1576 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5450
Phone (772) 337-4578

Other identifiers 1

IdentifierTypeStateIssuer
45124OtherFLBLUECROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1205897667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1576 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525450",
            "telephone_number": "772-337-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1576 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525450",
            "telephone_number": "772-337-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDAMEDCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "NAYYAR",
        "authorized_official_first_name": "MANJULA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "772-342-6911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME39359",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME30367",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "45124",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.