Active NPI
Robert P Nolan, PA
- Physician Assistant
- Hallandale Beach, FL
National Provider Identifier
1659645398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 3074
- Practice address
- 1724 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4611 - Phone
- (954) 454-9091
- Fax
- (954) 454-1711
- NPI assigned
- Feb 27, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 3074 | FL | Primary |
Addresses
Primary practice location
1724 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4611
Mailing address
2447 N 37TH Ave
Hollywood, FL 33021-3604
Phone (954) 274-8664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 3074 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330300800000",
"number": "1659645398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2447 N 37TH AVE",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330213604",
"telephone_number": "954-274-8664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1724 E HALLANDALE BEACH BLVD",
"city": "HALLANDALE BEACH",
"state": "FL",
"postal_code": "330094611",
"telephone_number": "954-454-9091",
"fax_number": "954-454-1711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "ROBERT",
"middle_name": "P",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-27",
"last_updated": "2012-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA 3074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hallandale Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.