Organization Active NPI

Lawrence E Broder M D P a

  • Medical Oncology Physician
  • Homestead, FL
National Provider Identifier
1679583769
Registry record updated Oct 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
ME0027628 Issued in FL
Legal business name
LAWRENCE E BRODER M D P A
Practice address
45 NW 8TH St
Suite 104
Homestead, FL 33030-4452
Phone
(305) 246-5500
Fax
(305) 246-0081
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2008

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

Authorized official

Name
Dr. Lawrence Broder
Title
President
Phone
(305) 238-1212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RX0202X ME0027628 FL Primary

Addresses

Primary practice location

45 NW 8TH St
Suite 104
Homestead, FL 33030-4452

Mailing address

8740 SW 182ND Ter
Village of Palmetto Bay, FL 33157-5952
Phone (305) 238-1212

Other identifiers 4

IdentifierTypeStateIssuer
210135OtherFLAMERIGROUP HMO
221246OtherFLAVMED HMO
370009700MedicaidFL
55027OtherFLJMH HMO

National Provider Directory

National Provider Directory

Locations

45 NW 8th St
Ste 104
Homestead, FL 33030
Phone (305) 246-5500

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225324800000",
    "number": "1679583769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8740 SW 182ND TER",
            "city": "VILLAGE OF PALMETTO BAY",
            "state": "FL",
            "postal_code": "331575952",
            "telephone_number": "305-238-1212",
            "fax_number": "305-238-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 NW 8TH ST",
            "address_2": "SUITE 104",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304452",
            "telephone_number": "305-246-5500",
            "fax_number": "305-246-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE E BRODER M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-10-30",
        "status": "A",
        "authorized_official_last_name": "BRODER",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-238-1212",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME0027628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP HMO",
            "identifier": "210135",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED HMO",
            "identifier": "221246",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370009700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JMH HMO",
            "identifier": "55027",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.