Prime Healing Corp

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PRIME HEALING CORP

Practice address

10101 W Sample Rd
Coral Springs, FL 33065-3907

Phone

(954) 864-3996

Fax

(347) 227-1368

NPI assigned

Oct 20, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Tony Oustabassidis

Title

Ceo

Phone

(954) 864-3996

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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

• Christine Lada

  • Family Nurse Practitioner
  • Parkland, FL
  • NPI 1790459485
  Medicare reassignment NPD
• Anil Kumar Dutt, MD

  • Surgery Physician
  • Titusville, PA
  • NPI 1134165699

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1571529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571529600000",
    "number": "1356984652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653907",
            "telephone_number": "954-864-3996",
            "fax_number": "347-227-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 W SAMPLE RD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330653907",
            "telephone_number": "954-864-3996",
            "fax_number": "347-227-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-20",
        "last_updated": "2019-10-20",
        "status": "A",
        "authorized_official_last_name": "OUSTABASSIDIS",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-864-3996",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Anthony Presutti, MD
• Marissa Prezzemolo, APRN, FNP-BC
• Savannah Price
• Shevaughn Priest
• Primary Care Physicians of Hollywood, PL
• Prime Pediatric Dental Group PA
• James S Prine, M.D.
• Malik Taj Dalen Pringle
• Priority Medical Centers, LLC
• Amber Pristas

• Multi-Specialty Clinic/Center in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2019; 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.