NPIMap

Organization Active NPI

South County Endocrinology P a

  • Endocrinology, Diabetes & Metabolism Physician
  • Boca Raton, FL
National Provider Identifier
1659337517
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME 67985 Issued in FL
Legal business name
SOUTH COUNTY ENDOCRINOLOGY P A
Practice address
670 Glades Rd
Suite 310
Boca Raton, FL 33431-6461
Phone
(561) 367-8202
Fax
(561) 367-8257
NPI assigned
Apr 20, 2006
Last updated
May 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Mirtha Kelijman, MDNPI 1538369962
Title
President
Phone
(561) 367-8202

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
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME 67985 FL Primary

Addresses

Primary practice location

670 Glades Rd
Suite 310
Boca Raton, FL 33431-6461

Mailing address

670 Glades Rd
Suite 310
Boca Raton, FL 33431-6461
Phone (561) 367-8202

Other identifiers 4

IdentifierTypeStateIssuer
252927OtherFLAVMED
44842OtherFLBLUE CROSS BLUE SHIELD OF FLA
FP0935OtherFLHEALTHNET
P00064212OtherFLRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

670 Glades Rd
Ste 310
Boca Raton, FL 33431
Phone (561) 367-8202

Practitioners & affiliated clinicians

Practitioners 5

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": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1659337517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 GLADES RD",
            "address_2": "SUITE 310",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316461",
            "telephone_number": "561-367-8202",
            "fax_number": "561-367-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 GLADES RD",
            "address_2": "SUITE 310",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316461",
            "telephone_number": "561-367-8202",
            "fax_number": "561-367-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COUNTY ENDOCRINOLOGY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "KELIJMAN",
        "authorized_official_first_name": "MIRTHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-367-8202",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME 67985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "252927",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLA",
            "identifier": "44842",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "FP0935",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00064212",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.