Active NPI
Deborah Ann Mulligan, M.D.
- Pediatric Emergency Medicine (Emergency Medicine) Physician
- Hollywood, FL
National Provider Identifier
1316974322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Emergency Medicine) Physician
- License
- ME61610
- Practice address
- 3501 Johnson St
Hollywood, FL 33021-5421 - Phone
- (954) 987-2000
- NPI assigned
- Jun 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | ME61610 | FL | Primary |
Addresses
Primary practice location
3501 Johnson St
Hollywood, FL 33021-5421
Mailing address
14050 NW 14TH St
Suite 190
Sunrise, FL 33323-2865
Phone (800) 424-3672
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14617 | Other | FL | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nova Southeastern University, Inc | Current | Accepting new patients | |
| Nova Southeastern University Inc. | Current | Accepting new patients | |
| Nova Southeastern University, Inc | Current | Accepting new patients | |
| Inphynet South Broward LLC | Pediatric Emergency Medicine | Past | Accepting new patients |
| Nova Southeastern University, Inc | Past | Accepting new patients |
Locations
3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250
650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213
1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Ft. Lauderdale, FL
- NPI 1700924511
-
- Clinical Medical Laboratory
- Ft. Lauderdale, FL
- NPI 1770533390
-
- Psychologist
- Ft. Lauderdale, FL
- NPI 1194991059
-
- Emergency Medicine Physician
- Hollywood, FL
- NPI 1871521880
Pediatric Emergency Medicine
-
- Family Medicine Physician
- Davie, FL
- NPI 1447345517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316974322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14050 NW 14TH ST",
"address_2": "SUITE 190",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232865",
"telephone_number": "800-424-3672",
"fax_number": "954-377-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 JOHNSON ST",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330215421",
"telephone_number": "954-987-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIGAN",
"first_name": "DEBORAH",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "FL",
"license": "ME61610",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "14617",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.