South Florida ADHD Center Inc.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

ME70979 Issued in FL

Legal business name

SOUTH FLORIDA ADHD CENTER INC.

Practice address

17901 NW 5TH St Ste 103
Pembroke Pines, FL 33029-2810

Phone

(305) 392-6784

NPI assigned

Dec 13, 2011

Last updated

Dec 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marisela Carmen Jaquez-Gutierrez, M.D.

Title

President

Phone

(305) 392-6784

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1427326800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11341 NW 50TH TER",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331783545",
            "telephone_number": "305-392-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 NW 5TH ST STE 103",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292810",
            "telephone_number": "305-392-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA ADHD CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "JAQUEZ-GUTIERREZ",
        "authorized_official_first_name": "MARISELA",
        "authorized_official_middle_name": "CARMEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-392-6784",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "ME70979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251098700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Broward Hospital District (Memorial Division of Adult Psychiatry at MHP)
• South Broward Kidney Assosciates PA
• South Broward Medical Management, Inc.
• South Broward Surgical Group LLC
• South Dental of Pembroke
• South Florida Baptist Group
• South Florida Cardiology Associates LLC
• South Florida Cardiology Consultants PA
• South Florida Community Health Centers, Inc.
• South Florida Doctors Group, PLLC

• Health Service Clinic/Center in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.