Sacred Heart Medical Office PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

ME64482 Issued in FL

Legal business name

SACRED HEART MEDICAL OFFICE PA

Practice address

17901 NW 5TH St
Suite 205
Pembroke Pines, FL 33029-2810

Phone

(954) 392-0333

Fax

(954) 392-0393

NPI assigned

Mar 12, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Yvelice A Villaman-Bencosme, MD

Title

Owner

Phone

(954) 392-0333

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9166/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1609199017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17901 NW 5TH ST",
            "address_2": "SUITE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292810",
            "telephone_number": "954-392-0333",
            "fax_number": "954-392-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 NW 5TH ST",
            "address_2": "SUITE 205",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292810",
            "telephone_number": "954-392-0333",
            "fax_number": "954-392-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART MEDICAL OFFICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "VILLAMAN-BENCOSME",
        "authorized_official_first_name": "YVELICE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-392-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME64482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001454700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ornella Lucia Saborido Battaglia, MD
• Ayhem Sabry, DC
• Tamer Attiah Sabry, D.C.
• Christine Anne Sacramento, ATC, NREMT-B
• Sacred Heart Medical Home, PA
• Bilal Sadiq, MD
• Kaywan Saed, DO
• Safe Space Wellness Services, LLC
• Sage Dental of Pembroke Pines, PLLC
• Janette Aloma Sahai, PHARMD

• Clinic/Center in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.