Organization Active NPI

Professional Medical Associates LLC

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1295053460
Registry record updated May 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME81885 Issued in FL
Legal business name
PROFESSIONAL MEDICAL ASSOCIATES LLC
Practice address
2301 N University Dr
Suite# 205
Pembroke Pines, FL 33024-3617
Phone
(954) 962-4680
Fax
(954) 966-6927
NPI assigned
May 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2010

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

Authorized official

Name
Dr. Zenobia Miro-Berkeley, M.D.
Title
President
Phone
(954) 962-4680

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME81885 FL Primary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X ME98247 FL

Addresses

Primary practice location

2301 N University Dr
Suite# 205
Pembroke Pines, FL 33024-3617

Mailing address

2301 N University Dr
Suite# 205
Pembroke Pines, FL 33024-3617
Phone (954) 962-4680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101110000344 FL Part B Supplier - Clinic/Group Practice 6507051091 Receives reassigned benefits from 1 practitioner
Practice locations: Pembroke Pines, 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
10D2008736Professional Medical Associates2301 N University Dr Ste 205, Pembroke Pines, FL 33024Certificate of waiverFeb 18, 2027

National Provider Directory

National Provider Directory

Locations

2301 N University Dr
Ste 205
Pembroke Pines, FL 33024
Phone (954) 612-5014

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": "1273622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273622400000",
    "number": "1295053460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N UNIVERSITY DR",
            "address_2": "SUITE# 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243617",
            "telephone_number": "954-962-4680",
            "fax_number": "954-966-6927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N UNIVERSITY DR",
            "address_2": "SUITE# 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243617",
            "telephone_number": "954-962-4680",
            "fax_number": "954-966-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-12",
        "last_updated": "2010-05-12",
        "status": "A",
        "authorized_official_last_name": "MIRO-BERKELEY",
        "authorized_official_first_name": "ZENOBIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-962-4680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME81885",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME98247",
            "primary": false
        }
    ],
    "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 May 12, 2010; 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.