Organization Active NPI

Sunsouth St. Jude Health Care, LLC

  • General Practice Physician
  • Pembroke Pines, FL
National Provider Identifier
1548037807
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SUNSOUTH ST. JUDE HEALTH CARE, LLC
Practice address
8374 Pines Blvd
Pembroke Pines, FL 33024-6616
Phone
(954) 429-6986
Fax
(954) 429-6987
NPI assigned
Dec 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Authorized official

Name
Carlos Arias
Title
Ceo
Phone
(352) 277-5305

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

8374 Pines Blvd
Pembroke Pines, FL 33024-6616

Mailing address

14690 Spring Hill Dr
Spring Hill, FL 34609-8102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240312000018 FL Part B Supplier - Clinic/Group Practice 3779929831 Receives reassigned benefits from 1 practitioner
Practice locations: North Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

8374 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 429-6986

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1548037807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14690 SPRING HILL DR",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346098102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8374 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246616",
            "telephone_number": "954-429-6986",
            "fax_number": "954-429-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSOUTH ST. JUDE HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "ARIAS",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-277-5305"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.