Patricia Lynn Peters, D.O.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

OS9406 Issued in FL

Practice address

12614 NW 23Rd Street
Pembroke Pines, FL 33028

Phone

(954) 612-2112

Fax

(954) 374-9270

NPI assigned

Jul 12, 2005

Last updated

Apr 5, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365120000000",
    "number": "1659379766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12614 NW 23RD ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282541",
            "telephone_number": "954-612-2112",
            "fax_number": "954-374-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12614 NW 23RD STREET",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33028",
            "telephone_number": "954-612-2112",
            "fax_number": "954-374-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2013-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS9406",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "OS9406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle Yvonne Perritte, LCSW
• Robert G Perry, M.D
• Brian Paul Pescatore, PT
• Alex Peskoe
• Ileana Pestana
• Robert A Peters, DC
• Alec Petersen
• Lina Maria Peterson, PT
• Ryan Petit, DO
• Emanuela Petrila, PT

• Adult Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.