St Croix Medical Group, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ST CROIX MEDICAL GROUP, INC.

Practice address

4010 NW 34TH St
Lauderdale Lakes, FL 33319-5721

Phone

(954) 486-7101

Fax

(954) 486-7102

NPI assigned

Jan 11, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Harry P Marcelin, PHARMDNPI 1457056061

Title

President

Phone

(954) 486-7101

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Ladonna Dahlpsyd Inc2 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.

• Ladonna Dahl,Psy.D., Inc.

  • Clinical Neuropsychologist
  • Boynton Beach, FL
  • NPI 1609114701
  NPD tax ID

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alain Christopher Marcelin, MD

  • Anesthesiology Physician
  • Vero Beach, FL
  • NPI 1831583707
  Medicare reassignment NPD
• Natacha Thony-Laurore, APRN

  • Family Nurse Practitioner
  • Boynton Beach, FL
  • NPI 1265903082
  Medicare reassignment NPD
• Marvin Marcelin, D.P.M.

  • Podiatrist
  • Philadelphia, PA
  • NPI 1053835264

  FL

  Medicare reassignment NPD
• Harry P Marcelin, PHARMD

  • Pharmacist
  • Lauderdale Lakes, FL
  • NPI 1457056061
  NPD Authorized official
• Yvrose Archange, MD

  • Internal Medicine Physician
  • Greenacres, FL
  • NPI 1902049216
  Medicare reassignment
• Barnette Benoit, FNP

  • Family Nurse Practitioner
  • Davie, FL
  • NPI 1780296772
  Medicare reassignment

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1346570546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 NW 34TH ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195721",
            "telephone_number": "954-486-7101",
            "fax_number": "954-486-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 NW 34TH ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195721",
            "telephone_number": "954-486-7101",
            "fax_number": "954-486-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CROIX MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-11",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "MARCELIN",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-486-7101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sovereign Business Management, Inc.
• Valentina Specoli
• Eugenie Spence, BSC, MA, DCC
• St Croix Medical Pharmacy
• St Johns Rehabilitation Hospital and Nursing Center Inc
• St Johns Rehabilitation Hospital and Nursing Center Inc
• St Joseph Residence Inc
• Denise St Patrick-Bell

• General Practice Physician in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.