Mizell Palliative Care Center

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

MIZELL PALLIATIVE CARE CENTER

Practice address

4801 S University Dr
#249
Davie, FL 33328-3839

Phone

(954) 680-4352

Fax

(954) 642-9438

NPI assigned

Dec 11, 2012

Organization subpart

No

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

Authorized official

Name

Guy C Jeanty, PHD

Title

Executive Director

Phone

(954) 895-1960

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355184000000",
    "number": "1679818090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 S UNIVERSITY DR",
            "address_2": "#249",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333283839",
            "telephone_number": "954-680-4352",
            "fax_number": "954-642-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 S UNIVERSITY DR",
            "address_2": "#249",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333283839",
            "telephone_number": "954-680-4352",
            "fax_number": "954-642-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIZELL PALLIATIVE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A",
        "authorized_official_last_name": "JEANTY",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "954-895-1960",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Supports Brokerage Agency in Davie, FL
• Providers in Davie, FL by specialty
• Supports Brokerage Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.

Verify at the official NPI Registry.