NPIMap

Organization Active NPI

Paula Bushman

  • Physiological Laboratory
  • Davie, FL
National Provider Identifier
1407022197
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
License
E2070 Issued in FL
Legal business name
PAULA BUSHMAN
Practice address
4020 SW 54TH Ave
Davie, FL 33314-3735
Phone
(866) 216-9283
NPI assigned
May 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Ms. Paula BushmanNPI 1033141221
Title
Owner
Phone
(866) 216-9283

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X E2070 FL Primary

Addresses

Primary practice location

4020 SW 54TH Ave
Davie, FL 33314-3735

Mailing address

4020 SW 54TH Ave
Davie, FL 33314-3735
Phone (866) 216-9283

Other identifiers 1

IdentifierTypeStateIssuer
V1484OtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • Altech Diagnostics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1407022197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 SW 54TH AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143735",
            "telephone_number": "866-216-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 SW 54TH AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143735",
            "telephone_number": "866-216-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULA BUSHMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "BUSHMAN",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-216-9283",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "FL",
            "license": "E2070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "V1484",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Altech Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.