Organization Active NPI

Stephen Z. Gervin, MD, Facs, Neuro Surgery PA

  • Specialist
  • Pembroke Pines, FL
National Provider Identifier
1265611321
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME13977 Issued in FL
Legal business name
STEPHEN Z. GERVIN, MD, FACS, NEURO SURGERY PA
Practice address
2301 N University Dr
Suite 210
Pembroke Pines, FL 33024-3617
Phone
(954) 961-3365
Fax
(954) 961-5629
NPI assigned
Oct 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Mrs. Robin Maceiras
Title
Admin
Phone
(954) 961-3365

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME13977 FL Primary

Addresses

Primary practice location

2301 N University Dr
Suite 210
Pembroke Pines, FL 33024-3617

Mailing address

2301 N University Dr
Suite 210
Pembroke Pines, FL 33024-3617
Phone (954) 961-3365

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040416001362 FL Part B Supplier - Clinic/Group Practice 7810982097 Receives reassigned benefits from 1 practitioner
Practice locations: Aventura, FL; Doral, FL; Pembroke Pines, FL

National Provider Directory

National Provider Directory

Locations

8180 NW 36th St
Ste 303
Doral, FL 33166
Phone (786) 517-6600

2221 N University Dr
Ste C
Pembroke Pines, FL 33024
Phone (904) 961-3365

Practitioners & affiliated clinicians

Practitioners 1

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": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1265611321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N UNIVERSITY DR",
            "address_2": "SUITE 210",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243617",
            "telephone_number": "954-961-3365",
            "fax_number": "954-961-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N UNIVERSITY DR",
            "address_2": "SUITE 210",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243617",
            "telephone_number": "954-961-3365",
            "fax_number": "954-961-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN Z. GERVIN, MD, FACS, NEURO SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "MACEIRAS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "954-961-3365",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME13977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 25, 2007; 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.