NPIMap

Organization Active NPI

Broward Urology LLC

  • Urology Physician
  • Pembroke Pines, FL
National Provider Identifier
1295734549
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME89935 Issued in FL
Legal business name
BROWARD UROLOGY LLC
Practice address
700 N Hiatus Rd
Suite 101
Pembroke Pines, FL 33026-5206
Phone
(954) 499-7696
Fax
(954) 499-7699
NPI assigned
Jul 19, 2005
Last updated
May 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Authorized official

Name
Michael A Simon, MDNPI 1700885761
Title
President
Phone
(954) 499-7696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME89935 FL Primary

Addresses

Primary practice location

700 N Hiatus Rd
Suite 101
Pembroke Pines, FL 33026-5206

Mailing address

700 N Hiatus Rd
Suite 101
Pembroke Pines, FL 33026-5206
Phone (954) 499-7696

Other identifiers 1

IdentifierTypeStateIssuer
98445OtherFLBCBS

National Provider Directory

National Provider Directory
Tax ID family
Broward Urology LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1295734549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N HIATUS RD",
            "address_2": "SUITE 101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265206",
            "telephone_number": "954-499-7696",
            "fax_number": "954-499-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N HIATUS RD",
            "address_2": "SUITE 101",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265206",
            "telephone_number": "954-499-7696",
            "fax_number": "954-499-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD UROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-499-7696",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME89935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "98445",
            "state": "FL"
        }
    ],
    "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 23, 2008; 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.