NPIMap

Organization Active NPI

Premiere Perinatal Associates PA

  • Maternal & Fetal Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1477502540
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
ME43546 Issued in FL
Legal business name
PREMIERE PERINATAL ASSOCIATES PA
Practice address
1600 S Andrews Ave
Premiere Perinatal Associates
Ft Lauderdale, FL 33316-2510
Phone
(954) 355-5110
Fax
(919) 425-0478
NPI assigned
May 8, 2006
Last updated
Oct 14, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Authorized official

Name
Kathy Kondas
Title
Officer
Phone
(954) 838-2371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X ME43546 FL Primary

Addresses

Primary practice location

1600 S Andrews Ave
Premiere Perinatal Associates
Ft Lauderdale, FL 33316-2510

Mailing address

500 SE 17TH St
Suite 100
Ft Lauderdale, FL 33316-2547
Phone (919) 425-1565

Other identifiers 1

IdentifierTypeStateIssuer
273189402MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1477502540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SE 17TH ST",
            "address_2": "SUITE 100",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162547",
            "telephone_number": "919-425-1565",
            "fax_number": "919-425-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "address_2": "PREMIERE PERINATAL ASSOCIATES",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-355-5110",
            "fax_number": "919-425-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE PERINATAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2019-10-14",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "954-838-2371"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "FL",
            "license": "ME43546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273189402",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.