NPIMap

Organization Active NPI

Cardiovascular Preventative Care, LLC

  • Cardiovascular Disease Physician
  • Pembroke Pines, FL
National Provider Identifier
1649671744
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME64325 Issued in FL
Legal business name
CARDIOVASCULAR PREVENTATIVE CARE, LLC
Practice address
1 SW 129TH Ave
Suite 105
Pembroke Pines, FL 33027-1761
Phone
(954) 425-6200
Fax
(941) 460-4097
NPI assigned
Sep 8, 2014
Last updated
Jun 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Daniel Norberg, MDNPI 1518910587
Title
Manager
Phone
(954) 425-6200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME64325 FL Primary

Addresses

Primary practice location

1 SW 129TH Ave
Suite 105
Pembroke Pines, FL 33027-1761

Mailing address

1 SW 129TH Ave
Suite 105
Pembroke Pines, FL 33027-1761
Phone (954) 425-6200

Other identifiers 3

IdentifierTypeStateIssuer
014065300MedicaidFL
IC289AOtherFLMEDICARE PTAN
HCC10249OtherFLAHCA LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1649671744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SW 129TH AVE",
            "address_2": "SUITE 105",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271761",
            "telephone_number": "954-425-6200",
            "fax_number": "941-460-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SW 129TH AVE",
            "address_2": "SUITE 105",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271761",
            "telephone_number": "954-425-6200",
            "fax_number": "941-460-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR PREVENTATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-08",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "NORBERG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-425-6200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME64325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014065300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IC289A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA  LICENSE",
            "identifier": "HCC10249",
            "state": "FL"
        }
    ],
    "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 Jun 9, 2015; 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.