NPIMap

Organization Active NPI

Pembroke Village Medical Center Inc

Doing business as Century Village Medical Center

  • Health Maintenance Organization
  • Pembroke Pines, FL
National Provider Identifier
1235378837
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
PEMBROKE VILLAGE MEDICAL CENTER INC
Doing business as
Century Village Medical Center
Practice address
13550 SW 10TH St
Pembroke Pines, FL 33027-6445
Phone
(954) 435-6001
Fax
(954) 435-6137
NPI assigned
Feb 5, 2009
Last updated
Dec 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Authorized official

Name
Robert D Camerlinck
Title
President
Phone
(561) 745-3877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X NU Primary

Addresses

Primary practice location

13550 SW 10TH St
Pembroke Pines, FL 33027-6445

Mailing address

250 S. Central Blvd
Suite 207
Jupiter, FL 33458
Phone (561) 745-3877

Other identifiers 1

IdentifierTypeStateIssuer
DA777AOtherFLPTAN

Other names 1

  • Century Village Medical Center Doing business as

National Provider Directory

National Provider Directory

Locations

250 S Central Blvd
Ste 207
Jupiter, FL 33458
Phone (561) 745-3877

13550 SW 10th St
Pembroke Pines, FL 33027
Phone (954) 433-9501

Practitioners & affiliated clinicians

Practitioners 6

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": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1235378837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S. CENTRAL BLVD",
            "address_2": "SUITE 207",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-745-3877",
            "fax_number": "561-745-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13550 SW 10TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330276445",
            "telephone_number": "954-435-6001",
            "fax_number": "954-435-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBROKE VILLAGE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "CAMERLINCK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-745-3877"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "DA777A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Century Village Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.