City of Pembroke Pines

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2813 Issued in FL

Legal business name

CITY OF PEMBROKE PINES

Practice address

9500 Pines Blvd
BLDG B
Pembroke Pines, FL 33024-6258

Phone

(954) 499-9600

NPI assigned

Feb 8, 2007

Last updated

Apr 17, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Penick

Title

Division Chief of Rescue

Phone

(954) 499-9584

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1710028410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 PINES BLVD",
            "address_2": "BUILDING B",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246258",
            "telephone_number": "954-499-9581",
            "fax_number": "954-517-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 PINES BLVD",
            "address_2": "BLDG B",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246258",
            "telephone_number": "954-499-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF PEMBROKE PINES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "PENICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DIVISION CHIEF OF RESCUE",
        "authorized_official_telephone_number": "954-499-9584"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "FL",
            "license": "2813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085063200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF FLORIDA",
            "identifier": "A0444",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MED",
            "identifier": "590000614",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAY WELL HEALTH PLAN",
            "identifier": "N7076",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariana Cisneros Silva
• Citrus Health Network-Cats
• Citrus Health Network, Inc.
• Citrus Health Network, Inc.
• Citrus Health Network,Inc.
• Dana Civil, PH.D.
• Jaret Clarke
• Martha Clarke, APRN
• Patricia Clarke, ARNP
• Pearlita Clarke

• Land Ambulance in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Land Ambulance in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.