Active NPI
Prestige Clinicians LLC
- Primary Care Clinic/Center
- Oakland Park, FL
National Provider Identifier
1497213755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- PRESTIGE CLINICIANS LLC
- Practice address
- 4513 NW 31St Ave Ste 1
Oakland Park, FL 33309-3403 - Phone
- (954) 496-2599
- Fax
- (954) 337-0236
- NPI assigned
- Mar 6, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Henry Odazie
- Title
- Authorized Official
- Phone
- (954) 669-0401
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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Primary Care Clinic/Center | 261QP2300X | Primary | ||
| Urgent Care Clinic/Center | 261QU0200X | |||
| Family Nurse Practitioner | 363LF0000X |
Addresses
Primary practice location
4513 NW 31St Ave Ste 1
Oakland Park, FL 33309-3403
Mailing address
4513 NW 31St Ave Ste 1
Oakland Park, FL 33309-3403
Phone (954) 496-2599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201111000879 | FL | Part B Supplier - Clinic/Group Practice | 9234549841 |
Receives reassigned benefits from 10 practitioners Practice locations: Fort Lauderdale, FL; Kissimmee, FL; Oakland Park, FL |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2233286 | Prestige Clinicians LLC | Certificate of waiver | Aug 22, 2027 |
National Provider Directory
National Provider DirectoryLocations
4513 NW 31st Ave
Ste 1
Oakland Park, FL 33309
Phone (954) 496-2599
Interoperability endpoints
- https://api.platform.athenahealth.com/23897/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 20
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Anatomic Pathology & Clinical Pathology Physician
- Tampa, FL
- NPI 1942663364
FL
-
- Psychiatric/Mental Health Nurse Practitioner
- Clearwater, FL
- NPI 1245926146
-
- Psychiatric/Mental Health Nurse Practitioner
- Coral Springs, FL
- NPI 1205647666
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788307200000",
"number": "1497213755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4513 NW 31ST AVE STE 1",
"city": "OAKLAND PARK",
"state": "FL",
"postal_code": "333093403",
"telephone_number": "954-496-2599",
"fax_number": "954-337-0236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4513 NW 31ST AVE STE 1",
"city": "OAKLAND PARK",
"state": "FL",
"postal_code": "333093403",
"telephone_number": "954-496-2599",
"fax_number": "954-337-0236"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRESTIGE CLINICIANS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-06",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A",
"authorized_official_last_name": "ODAZIE",
"authorized_official_first_name": "HENRY",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "954-669-0401",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.