Professional Healthcare Group, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

OS3754 Issued in FL

Legal business name

PROFESSIONAL HEALTHCARE GROUP, LLC

Practice address

150 SW 12TH Ave
Suite 440
Pompano Beach, FL 33069-3298

Phone

(954) 943-8902

NPI assigned

Feb 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Stewart E Kopp, D.O.

Title

Medical Director

Phone

(954) 943-8902

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1639347214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SW 12TH AVE",
            "address_2": "SUITE 440",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330693298",
            "telephone_number": "954-943-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SW 12TH AVE",
            "address_2": "SUITE 440",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330693298",
            "telephone_number": "954-943-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEALTHCARE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "KOPP",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "954-943-8902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS3754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.