NPIMap

Organization Active NPI

Prestige Clinicians LLC

  • Primary Care Clinic/Center
  • Oakland Park, FL
National Provider Identifier
1497213755
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
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
Last updated
Sep 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Mr. Henry OdazieNPI 1740880848
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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Primary Care Clinic/Center 261QP2300X Primary
Urgent Care Clinic/Center 261QU0200X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2233286Prestige Clinicians LLC4513 NW 31St Ave, Oakland Park, FL 33309Certificate of waiverAug 22, 2027

National Provider Directory

National Provider Directory

Locations

406 E Vine St
Rm C
Kissimmee, FL 34744
Phone 9542710291201

4513 NW 31st Ave
Oakland Park, FL 33309
Phone (954) 496-2599

4513 NW 31st Ave
Ste 1
Oakland Park, FL 33309
Phone (954) 496-2599

Interoperability endpoints

  • FHIR API: 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, and the practitioner matching its NPPES authorized official.

View all 20

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.

Verify at the official NPI Registry.