Primetime Medical Group LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRIMETIME MEDICAL GROUP LLC

Practice address

1975 E Sunrise Blvd Ste 501
Fort Lauderdale, FL 33304-1410

Phone

(954) 512-0522

NPI assigned

Aug 18, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Pelsha DariusNPI 1043828254

Title

Ceo

Phone

(954) 512-0522

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Pelsha Darius

  • Durable Medical Equipment & Medical Supplies
  • Fort Lauderdale, FL
  • NPI 1043828254
  NPD Authorized official

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1568074078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 E SUNRISE BLVD STE 501",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041410",
            "telephone_number": "954-512-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 E SUNRISE BLVD STE 501",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041410",
            "telephone_number": "954-512-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMETIME MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "DARIUS",
        "authorized_official_first_name": "PELSHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-512-0522",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "D620670872821",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.