Weston Medical Clinic Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0073727 Issued in FL

Legal business name

WESTON MEDICAL CLINIC INC

Practice address

17120 Royal Palm Blvd
Suite 4
Weston, FL 33326-2310

Phone

(954) 385-3711

Fax

(954) 385-9366

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

Phanor Calle, M.D.NPI 1346269362

Title

President

Phone

(954) 385-9711

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Phanor Calle, M.D.

  • Internal Medicine Physician
  • Weston, FL
  • NPI 1346269362
  NPD (past) Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1609894484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17120 ROYAL PALM BLVD",
            "address_2": "SUITE 4",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333262310",
            "telephone_number": "954-385-3711",
            "fax_number": "954-385-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17120 ROYAL PALM BLVD",
            "address_2": "SUITE 4",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333262310",
            "telephone_number": "954-385-3711",
            "fax_number": "954-385-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTON MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "CALLE",
        "authorized_official_first_name": "PHANOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-385-9711",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0073727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255505100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Weston Eye Care LLC
• Weston Eye Center, Inc.
• Weston Family Practice PA
• Weston Hyperbaric Therapy LLC
• Weston Laser & Vision Institute, Inc
• Weston Medical Health & Wellness, Inc
• Weston Medical Health Center, LLC
• Weston Modern Dentistry, PA
• Weston Outpatient Surgical Center LTD
• Weston Peciatric Group PA

• Internal Medicine Physician in Weston, FL
• Providers in Weston, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.