Thiago Queiroz DO PA, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

THIAGO QUEIROZ DO PA, LLC

Practice address

3487 NW 30TH St
Lauderdale Lakes, FL 33311-1103

Phone

(205) 835-4655

NPI assigned

Aug 30, 2022

Organization subpart

No

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

Authorized official

Name

Thiago Queiroz, DONPI 1558752618

Title

President

Phone

(205) 835-4655

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Thiago Queiroz, D.O.

  • General Practice Physician
  • South Miami, FL
  • NPI 1558752618

  Physical Medicine & Rehabilitation

  Medicare reassignment NPD Authorized official
• Yaisel Barrero Mollinea, APRN

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1497431712
  Medicare reassignment NPD
• Charl Hwan Woo, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Miami, FL
  • NPI 1063883585
  Medicare reassignment NPD

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1386364495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10741 SW 53RD ST",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333285639",
            "telephone_number": "205-835-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3487 NW 30TH ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333111103",
            "telephone_number": "205-835-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIAGO QUEIROZ DO PA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "QUEIROZ",
        "authorized_official_first_name": "THIAGO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-835-4655",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thelma Elizabeth Tennie, PHD
• Sarah A. Thayil, LCSW
• The Family Practice of Tamarac, Corp
• The Hair Laboratory
• Ulrick Theoc
• Ha Thanh Thomas
• Jaime Thomas
• Jennifer Thomas, LPN
• Paule Thomas, NP
• Rickey James Thomas I, REGISTRED INTERN

• Physical Medicine & Rehabilitation Physician in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.