Promedical Centers Corp

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME78770 Issued in FL

Legal business name

PROMEDICAL CENTERS CORP

Practice address

3402 N Andrews Avenue Ext
Pompano Beach, FL 33064-2067

Phone

(954) 368-1302

Fax

(954) 582-6715

NPI assigned

Feb 24, 2017

Organization subpart

No

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

Authorized official

Name

Rene Casanova, MD

Title

Medical Director

Phone

(954) 526-0840

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1689114654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SAWGRASS CORPORATE PKWY",
            "address_2": "SUITE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333256269",
            "telephone_number": "954-526-0840",
            "fax_number": "954-526-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 N ANDREWS AVENUE EXT",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330642067",
            "telephone_number": "954-368-1302",
            "fax_number": "954-582-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICAL CENTERS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "CASANOVA",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "954-526-0840",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME78770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.