Coral Ridge Professional Group LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CORAL RIDGE PROFESSIONAL GROUP LLC

Practice address

9633 W Broward Blvd
Suite 6
Plantation, FL 33324-2332

Phone

(561) 202-0834

NPI assigned

Aug 14, 2012

Organization subpart

No

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

Authorized official

Name

Tammy Rodriguez

Title

Billing Manager

Phone

(561) 202-0834

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1215284757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9633 W BROWARD BLVD",
            "address_2": "SUITE 6",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9633 W BROWARD BLVD",
            "address_2": "SUITE 6",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242332",
            "telephone_number": "561-202-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL RIDGE PROFESSIONAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "561-202-0834"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Plantation, FL
• Providers in Plantation, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.