NPIMap

Organization Active NPI

Broward Children'S Center

  • Pediatric Dentistry
  • Pompano Beach, FL
National Provider Identifier
1295974293
Registry record updated Feb 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
BROWARD CHILDREN'S CENTER
Practice address
200 SE 19TH Ave
Pompano Beach, FL 33060-7543
Phone
(954) 943-7638
Fax
(954) 943-5950
NPI assigned
Feb 13, 2009
Organization subpart
Yes
Parent organization
NOVA SOUTHEASTERN UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2009

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

Authorized official

Name
Robert S. Oller, D.O.
Title
Ceo / Clinical Operations
Phone
(954) 262-4343

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

200 SE 19TH Ave
Pompano Beach, FL 33060-7543

Mailing address

3200 S University Dr
Assembly BLDG # 2 Room 202
Davie, FL 33328-2018
Phone (954) 262-4343

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
10D0887354Broward Children'S Center Inc200 SE 19TH Avenue, Pompano Beach, FL 33060Certificate of waiverJun 9, 2028

National Provider Directory

National Provider Directory
Tax ID family
Nova Southeaster Univ38 organizations share this tax ID, including this one
Part of
Nova Southeaster Univ

Other organizations with this tax ID 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234483200000",
    "number": "1295974293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "ASSEMBLY BLDG # 2 ROOM 202",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-4343",
            "fax_number": "954-262-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE 19TH AVE",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330607543",
            "telephone_number": "954-943-7638",
            "fax_number": "954-943-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD CHILDREN'S CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOVA SOUTHEASTERN UNIVERSITY",
        "enumeration_date": "2009-02-13",
        "last_updated": "2009-02-13",
        "status": "A",
        "authorized_official_last_name": "OLLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO / CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "954-262-4343",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.