Organization Active NPI

Clifford a Lakin MD P a

  • Surgery Physician
  • Ft Lauderdale, FL
National Provider Identifier
1346492030
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME16123 Issued in FL
Legal business name
CLIFFORD A LAKIN MD P A
Practice address
4640 N Federal Hwy Ste D
Ft Lauderdale, FL 33308-5205
Phone
(954) 491-1095
Fax
(954) 491-1097
NPI assigned
Oct 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Authorized official

Name
Dr. Clifford A Lakin, M.D.
Title
Owner
Phone
(954) 491-1095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X ME16123 FL Primary

Addresses

Primary practice location

4640 N Federal Hwy Ste D
Ft Lauderdale, FL 33308-5205

Mailing address

4640 N Federal Hwy Ste D
Ft Lauderdale, FL 33308-5205
Phone (954) 491-1095

Other identifiers 1

IdentifierTypeStateIssuer
0594521-00MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1346492030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 N FEDERAL HWY STE D",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085205",
            "telephone_number": "954-491-1095",
            "fax_number": "954-491-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 N FEDERAL HWY STE D",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085205",
            "telephone_number": "954-491-1095",
            "fax_number": "954-491-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFFORD A LAKIN MD P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "LAKIN",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-491-1095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME16123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0594521-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.