Active NPI
Bethesda Medical Clinic, LLC
- Internal Medicine Physician
- Davie, FL
National Provider Identifier
1710450267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- BETHESDA MEDICAL CLINIC, LLC
- Practice address
- 11050 Griffin Rd Ste 104
Davie, FL 33328-3227 - Phone
- (954) 824-1922
- Fax
- (954) 281-9446
- NPI assigned
- Jan 8, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shibu Varughese
- Title
- Medical Director
- Phone
- (504) 265-8304
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | |||
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | |||
| Hematology & Oncology Physician | 207RH0003X |
Addresses
Primary practice location
11050 Griffin Rd Ste 104
Davie, FL 33328-3227
Mailing address
11050 Griffin Rd Ste 104
Davie, FL 33328-3227
Phone (954) 824-1922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1151 Barataria Blvd
Ste 3400
Marrero, LA 70072
Phone (504) 265-8304
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EHFGBD
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Hospitalist Physician
- Metairie, LA
- NPI 1780094482
-
- Family Nurse Practitioner
- New Orleans, LA
- NPI 1740972090
-
- Nurse Practitioner
- Baton Rouge, LA
- NPI 1265769327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546905600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1783296000000",
"number": "1710450267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11050 GRIFFIN RD STE 104",
"city": "DAVIE",
"state": "FL",
"postal_code": "333283227",
"telephone_number": "954-824-1922",
"fax_number": "954-281-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11050 GRIFFIN RD STE 104",
"city": "DAVIE",
"state": "FL",
"postal_code": "333283227",
"telephone_number": "954-824-1922",
"fax_number": "954-281-9446"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BETHESDA MEDICAL CLINIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-01-08",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A",
"authorized_official_last_name": "VARUGHESE",
"authorized_official_first_name": "SHIBU",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "504-265-8304",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RE0101X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hematology & Oncology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.