Mark Broudo M D P a

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME74337 Issued in FL

Legal business name

MARK BROUDO M D P A

Practice address

1100 SW 57TH Ave
Suite 100
West Miami, FL 33144-5129

Phone

(305) 262-6484

NPI assigned

Apr 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark Broudo, MD

Title

President

Phone

(305) 262-6484

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Nidal Masri, M.D.

  • Plastic Surgery Physician
  • West Miami, FL
  • NPI 1396825105
  NPD (past)

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1477797413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SW 57TH AVE",
            "address_2": "SUITE 100",
            "city": "WEST MIAMI",
            "state": "FL",
            "postal_code": "331445129",
            "telephone_number": "305-262-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SW 57TH AVE",
            "address_2": "SUITE 100",
            "city": "WEST MIAMI",
            "state": "FL",
            "postal_code": "331445129",
            "telephone_number": "305-262-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK BROUDO M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "BROUDO",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-262-6484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME74337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ma Medical Supply Inc
• Mam Health Enterprises Inc.
• Nurys Cristina Manresa Cisneros
• Manzur Rehabilitation Center Inc
• Yirka Marin
• Lois H Marrero, DDS
• Felipe Martinez, M.D.
• Kirenia Martinez, FNP-BC, PMHNP-BC
• Yadelmis Marzabal
• Nidal Masri, M.D.

• Plastic Surgery Physician in West Miami, FL
• Providers in West Miami, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.