Pembroke Pavilion Psychiatric Associates, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0025377 Issued in FL

Legal business name

PEMBROKE PAVILION PSYCHIATRIC ASSOCIATES, INC

Practice address

1000 N Hiatus Rd
Suite 140
Pembroke Pines, FL 33026-3097

Phone

(954) 431-9838

Fax

(954) 433-7066

NPI assigned

Sep 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Abraham Flemenbaum, MD

Title

President

Phone

(954) 431-9838

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1487962098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N HIATUS RD",
            "address_2": "SUITE 140",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263097",
            "telephone_number": "954-431-9838",
            "fax_number": "954-433-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N HIATUS RD",
            "address_2": "SUITE 140",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263097",
            "telephone_number": "954-431-9838",
            "fax_number": "954-433-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBROKE PAVILION PSYCHIATRIC ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "FLEMENBAUM",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-431-9838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0025377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0383290500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.